Provider Demographics
NPI:1750315131
Name:WEST SHORE EDUCATIONAL SERVICE DISTRICT
Entity type:Organization
Organization Name:WEST SHORE EDUCATIONAL SERVICE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL ED DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MUELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-757-3716
Mailing Address - Street 1:2130 WEST US 10
Mailing Address - Street 2:
Mailing Address - City:LUDINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49431-9307
Mailing Address - Country:US
Mailing Address - Phone:231-757-3716
Mailing Address - Fax:231-757-4208
Practice Address - Street 1:2130 WEST US 10
Practice Address - Street 2:
Practice Address - City:LUDINGTON
Practice Address - State:MI
Practice Address - Zip Code:49431-9307
Practice Address - Country:US
Practice Address - Phone:231-757-3716
Practice Address - Fax:231-757-4208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2975903Medicaid