Provider Demographics
NPI:1275712945
Name:SCHOOL DISTRICT OF BONDUEL
Entity type:Organization
Organization Name:SCHOOL DISTRICT OF BONDUEL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:BEHNKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-758-4860
Mailing Address - Street 1:400 W GREEN BAY ST
Mailing Address - Street 2:PO BOX 310
Mailing Address - City:BONDUEL
Mailing Address - State:WI
Mailing Address - Zip Code:54107-9302
Mailing Address - Country:US
Mailing Address - Phone:715-758-4860
Mailing Address - Fax:715-758-4459
Practice Address - Street 1:400 W GREEN BAY ST
Practice Address - Street 2:
Practice Address - City:BONDUEL
Practice Address - State:WI
Practice Address - Zip Code:54107-9302
Practice Address - Country:US
Practice Address - Phone:715-758-4860
Practice Address - Fax:715-758-4459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44209100Medicaid