Provider Demographics
NPI:1134344914
Name:GREENFIELD SCHOOL DISTRICT
Entity type:Organization
Organization Name:GREENFIELD SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLLATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-525-5818
Mailing Address - Street 1:8500 W CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53228-2915
Mailing Address - Country:US
Mailing Address - Phone:414-525-5818
Mailing Address - Fax:414-529-9478
Practice Address - Street 1:8500 W CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53228-2915
Practice Address - Country:US
Practice Address - Phone:414-525-5818
Practice Address - Fax:414-529-9478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44234900Medicaid