Provider Demographics
NPI:1720267693
Name:CENTRAL HIGH SCHOOL DISTRICT OF WESTOSHA
Entity Type:Organization
Organization Name:CENTRAL HIGH SCHOOL DISTRICT OF WESTOSHA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:R.
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-843-2321
Mailing Address - Street 1:24617 75TH ST
Mailing Address - Street 2:PO BOX 38
Mailing Address - City:SALEM
Mailing Address - State:WI
Mailing Address - Zip Code:53168
Mailing Address - Country:US
Mailing Address - Phone:262-843-2321
Mailing Address - Fax:262-843-4069
Practice Address - Street 1:24617 75TH ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:WI
Practice Address - Zip Code:53168
Practice Address - Country:US
Practice Address - Phone:262-843-2321
Practice Address - Fax:262-843-4069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44205500Medicaid