Healthcare Provider Details

I. General information

NPI: 1851572408
Provider Name (Legal Business Name): NORTH LAKELAND SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2007
Last Update Date: 07/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12686 COUNTY HWY K
MANITOWISH WATERS WI
54545
US

IV. Provider business mailing address

12686 COUNTY HWY K
MANITOWISH WATERS WI
54545
US

V. Phone/Fax

Practice location:
  • Phone: 715-543-8417
  • Fax: 715-543-8868
Mailing address:
  • Phone: 715-543-8417
  • Fax: 715-543-8868

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: RICHARD VOUGHT
Title or Position: DISTRICT ADMINISTRATOR
Credential:
Phone: 715-543-8417