Provider Demographics
NPI:1700068251
Name:SCHOOL DISTRICT OF SPRING VALLEY
Entity Type:Organization
Organization Name:SCHOOL DISTRICT OF SPRING VALLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WELLINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-778-5551
Mailing Address - Street 1:S1450 CTY ROAD CC
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:WI
Mailing Address - Zip Code:54767
Mailing Address - Country:US
Mailing Address - Phone:715-778-5551
Mailing Address - Fax:
Practice Address - Street 1:S1450 CTY ROAD CC
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:WI
Practice Address - Zip Code:54767
Practice Address - Country:US
Practice Address - Phone:715-778-5551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44238300Medicaid