Provider Demographics
NPI:1609042027
Name:CESA #3
Entity Type:Organization
Organization Name:CESA #3
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:LORETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIEMENAPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-822-3276
Mailing Address - Street 1:1300 INDUSTRIAL DR
Mailing Address - Street 2:
Mailing Address - City:FENNIMORE
Mailing Address - State:WI
Mailing Address - Zip Code:53809-9702
Mailing Address - Country:US
Mailing Address - Phone:608-822-3276
Mailing Address - Fax:608-822-3828
Practice Address - Street 1:1300 INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:FENNIMORE
Practice Address - State:WI
Practice Address - Zip Code:53809-9702
Practice Address - Country:US
Practice Address - Phone:608-822-3276
Practice Address - Fax:608-822-3828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44202100Medicaid