Provider Demographics
NPI:1184803819
Name:WINTER SCHOOL DISTRICT
Entity type:Organization
Organization Name:WINTER SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOILEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-266-3301
Mailing Address - Street 1:PO BOX 310
Mailing Address - Street 2:
Mailing Address - City:WINTER
Mailing Address - State:WI
Mailing Address - Zip Code:54896-0310
Mailing Address - Country:US
Mailing Address - Phone:715-266-3301
Mailing Address - Fax:715-266-2216
Practice Address - Street 1:6585 W GROVE ST
Practice Address - Street 2:
Practice Address - City:WINTER
Practice Address - State:WI
Practice Address - Zip Code:54896-7665
Practice Address - Country:US
Practice Address - Phone:715-266-3301
Practice Address - Fax:715-266-2216
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
WI44230800Medicaid