Healthcare Provider Details

I. General information

NPI: 1013196724
Provider Name (Legal Business Name): AUGUSTA SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2007
Last Update Date: 10/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

E19320 BARTIG RD
AUGUSTA WI
54722-7501
US

IV. Provider business mailing address

E19320 BARTIG RD
AUGUSTA WI
54722-7501
US

V. Phone/Fax

Practice location:
  • Phone: 715-286-3301
  • Fax:
Mailing address:
  • Phone: 715-286-3301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: STEVE LAFAVE
Title or Position: ADMINISTRATOR
Credential:
Phone: 715-286-3301