Provider Demographics
NPI:1366615452
Name:CEDAR GROVE-BELGIUM AREA SCHOOL DISTRICT
Entity type:Organization
Organization Name:CEDAR GROVE-BELGIUM AREA SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RABE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-668-8518
Mailing Address - Street 1:321 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53013-1641
Mailing Address - Country:US
Mailing Address - Phone:920-668-8518
Mailing Address - Fax:920-668-6933
Practice Address - Street 1:321 N 2ND ST
Practice Address - Street 2:
Practice Address - City:CEDAR GROVE
Practice Address - State:WI
Practice Address - Zip Code:53013-1641
Practice Address - Country:US
Practice Address - Phone:920-668-8518
Practice Address - Fax:920-668-6933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44218800Medicaid