Provider Demographics
NPI:1699969840
Name:MEQUON-THIENSVILLE SCHOOL DISTRICT
Entity type:Organization
Organization Name:MEQUON-THIENSVILLE SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PUPIL SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:JOYCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-238-8501
Mailing Address - Street 1:5000 W MEQUON RD
Mailing Address - Street 2:
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53092-2044
Mailing Address - Country:US
Mailing Address - Phone:262-238-8501
Mailing Address - Fax:262-238-8520
Practice Address - Street 1:5000 W MEQUON RD
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-2044
Practice Address - Country:US
Practice Address - Phone:262-238-8501
Practice Address - Fax:262-238-8520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI347B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347B00000XTransportation ServicesBus
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44222900Medicaid