Provider Demographics
NPI:1023282308
Name:RICHFIELD JOINT SCHOOL DISTRICT NO. 1
Entity type:Organization
Organization Name:RICHFIELD JOINT SCHOOL DISTRICT NO. 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLIOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:MOESER
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:262-628-1032
Mailing Address - Street 1:3117 HOLY HILL ROAD, P. O. BOX 127
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53076
Mailing Address - Country:US
Mailing Address - Phone:262-628-1032
Mailing Address - Fax:262-628-3013
Practice Address - Street 1:3117 HOLY HILL ROAD
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:WI
Practice Address - Zip Code:53076
Practice Address - Country:US
Practice Address - Phone:262-628-1032
Practice Address - Fax:262-628-3013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44243400Medicaid