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General NPI Number Information
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NPI Number | 1275964025
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Entity Type | Organization
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Legal Business Name | ROCKETSHIP EDUCATION WISCONSIN INC.
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Dates
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Enumeration Date | 12/04/2013
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Last Update Date | 12/04/2013
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Provider Practice Location Address
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Address Line | 3003 WEST CLEVELAND AVENUE
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City | MILWAUKEE
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State | WI
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Zip | 53215
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Country | US
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Telephone | 414-455-3539
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Fax |
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Provider Business Mailing Address
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Address Line | 350 TWIN DOLPHIN DR SUITE 109
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City | REDWOOD CITY
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State | CA
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Zip | 94065-1457
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Country | US
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Telephone | 877-806-0920
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Fax |
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Authorized Official
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Title or Position | CHIEF BUSINESS OFFICER
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Name | ANDREW STERN
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Credential |
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Telephone | 877-806-0920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | 251300000X
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License Number State | WI
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