Provider Demographics
NPI:1891974564
Name:GRANTON SCHOOL DISTRICT
Entity Type:Organization
Organization Name:GRANTON SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:REHM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-238-7292
Mailing Address - Street 1:217 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GRANTON
Mailing Address - State:WI
Mailing Address - Zip Code:54436-7835
Mailing Address - Country:US
Mailing Address - Phone:715-238-7292
Mailing Address - Fax:715-238-7288
Practice Address - Street 1:217 N MAIN ST
Practice Address - Street 2:
Practice Address - City:GRANTON
Practice Address - State:WI
Practice Address - Zip Code:54436-7835
Practice Address - Country:US
Practice Address - Phone:715-238-7292
Practice Address - Fax:715-238-7288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44232700Medicaid