Organization
CLINTONVILLE PUBLIC SCHOOL DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYRENE SCHULTZ (DIRECTOR OF PUPIL SERVICES)
(715) 823-7215
Entity
Organization
Contact information
Practice address
45 W GREEN TREE RD, CLINTONVILLE, WI 54929-1055
(715) 823-7215
(715) 823-1315
Mailing address
25 8TH ST, CLINTONVILLE, WI 54929-1607
(715) 823-7215
(715) 823-1477
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44202400
MEDICAID PROVIDER NUMBER
WI
Enumeration date
04/18/2008
Last updated
04/18/2008
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