Provider Demographics
NPI:1659544666
Name:D.C. EVEREST AREA SCHOOLS
Entity Type:Organization
Organization Name:D.C. EVEREST AREA SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUPIL SERVICES & SPECIAL EDUCATION
Authorized Official - Prefix:
Authorized Official - First Name:TRUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:DESIMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-359-4221
Mailing Address - Street 1:6300 ALDERSON ST
Mailing Address - Street 2:
Mailing Address - City:SCHOFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54476-3906
Mailing Address - Country:US
Mailing Address - Phone:715-359-4221
Mailing Address - Fax:715-359-2056
Practice Address - Street 1:6300 ALDERSON ST
Practice Address - Street 2:
Practice Address - City:SCHOFIELD
Practice Address - State:WI
Practice Address - Zip Code:54476-3906
Practice Address - Country:US
Practice Address - Phone:715-359-4221
Practice Address - Fax:715-359-2056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44217000Medicaid