Provider Demographics
NPI:1720267347
Name:RIB LAKE SCHOOL DISTRICT
Entity Type:Organization
Organization Name:RIB LAKE SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:TORTOMASI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-427-3222
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:RIB LAKE
Mailing Address - State:WI
Mailing Address - Zip Code:54470-0278
Mailing Address - Country:US
Mailing Address - Phone:715-427-3222
Mailing Address - Fax:715-427-3221
Practice Address - Street 1:1236 KENNEDY ST
Practice Address - Street 2:
Practice Address - City:RIB LAKE
Practice Address - State:WI
Practice Address - Zip Code:54470-9457
Practice Address - Country:US
Practice Address - Phone:715-427-3222
Practice Address - Fax:715-427-3221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44236500Medicaid