Provider Demographics
NPI:1750467742
Name:GROTON AREA SCHOOL DISTRICT
Entity Type:Organization
Organization Name:GROTON AREA SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-397-2351
Mailing Address - Street 1:125 EAST 4TH AVE.
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:SD
Mailing Address - Zip Code:57445-0410
Mailing Address - Country:US
Mailing Address - Phone:605-397-2351
Mailing Address - Fax:605-397-8453
Practice Address - Street 1:125 EAST 4TH AVE.
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:SD
Practice Address - Zip Code:57445-0410
Practice Address - Country:US
Practice Address - Phone:605-397-2351
Practice Address - Fax:605-397-8453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5151120Medicaid