Provider Demographics
NPI:1285885517
Name:WRIGHTSTOWN COMMUNITY SCHOOL DISTRICT
Entity type:Organization
Organization Name:WRIGHTSTOWN COMMUNITY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PUPIL SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:KENDILYN
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:BROCKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-532-0525
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:WRIGHTSTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:54180-0128
Mailing Address - Country:US
Mailing Address - Phone:920-532-0525
Mailing Address - Fax:
Practice Address - Street 1:351 HIGH ST
Practice Address - Street 2:
Practice Address - City:WRIGHTSTOWN
Practice Address - State:WI
Practice Address - Zip Code:54180-1131
Practice Address - Country:US
Practice Address - Phone:920-532-0525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44244000Medicaid