Provider Demographics
NPI:1770861247
Name:COLBY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:COLBY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-223-2301
Mailing Address - Street 1:725 W PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-3276
Mailing Address - Country:US
Mailing Address - Phone:715-720-2058
Mailing Address - Fax:715-720-2070
Practice Address - Street 1:505 W SPENCE ST
Practice Address - Street 2:
Practice Address - City:COLBY
Practice Address - State:WI
Practice Address - Zip Code:54421-9644
Practice Address - Country:US
Practice Address - Phone:715-223-2301
Practice Address - Fax:715-223-4539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44232000Medicaid