Healthcare Provider Details

I. General information

NPI: 1447566286
Provider Name (Legal Business Name): DARLINGTON COMMUNITY SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2010
Last Update Date: 08/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11630 CENTER HILL RD
DARLINGTON WI
53530-9231
US

IV. Provider business mailing address

11630 CENTER HILL RD
DARLINGTON WI
53530-9231
US

V. Phone/Fax

Practice location:
  • Phone: 608-776-2006
  • Fax: 608-776-3407
Mailing address:
  • Phone: 608-776-2006
  • Fax: 608-776-3407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License Number331295
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number331295
License Number StateWI

VIII. Authorized Official

Name: DR. DENISE LYNN WELLNITZ
Title or Position: DISTRICT ADMINISTRATOR
Credential: ED. D
Phone: 608-776-2006