Provider Demographics
NPI:1205069580
Name:WACONDA
Entity type:Organization
Organization Name:WACONDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-781-4328
Mailing Address - Street 1:708 LOCUST ST
Mailing Address - Street 2:BOX 326
Mailing Address - City:CAWKER CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67430-9246
Mailing Address - Country:US
Mailing Address - Phone:785-781-4328
Mailing Address - Fax:
Practice Address - Street 1:708 LOCUST ST
Practice Address - Street 2:BOX 326
Practice Address - City:CAWKER CITY
Practice Address - State:KS
Practice Address - Zip Code:67430-9246
Practice Address - Country:US
Practice Address - Phone:785-781-4328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BELOIT SPECIAL EDUCATION COOP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)