Provider Demographics
NPI:1629259775
Name:SCHOOL DISTRICT OF NEW GLARUS
Entity Type:Organization
Organization Name:SCHOOL DISTRICT OF NEW GLARUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:R
Authorized Official - Last Name:KRANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-527-2410
Mailing Address - Street 1:PO BOX 7
Mailing Address - Street 2:1701 SECOND STREET
Mailing Address - City:NEW GLARUS
Mailing Address - State:WI
Mailing Address - Zip Code:53574
Mailing Address - Country:US
Mailing Address - Phone:608-527-2410
Mailing Address - Fax:608-527-5101
Practice Address - Street 1:1701 SECOND STREET
Practice Address - Street 2:
Practice Address - City:NEW GLARUS
Practice Address - State:WI
Practice Address - Zip Code:53574
Practice Address - Country:US
Practice Address - Phone:608-527-2410
Practice Address - Fax:608-527-5101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44223100Medicaid