| Organization Name: | COOPERATIVE EDUCATIONAL SERVICE AGENCY #12 |
| NPI Number: | 1851570022 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THOMAS POTTERTON (DIRECTOR OF SPECIAL EDUCATION) |
| Mailing Address: | 618 Beaser Ave Ashland |
| State: | WI US |
| Postal Code: | 548062751 |
| Phone Number: | 7156822363 |
| Fax Number: | 7156827244 |
| NPI Enumeration Date: | 10/24/2007 |
| NPI Last Update Date: | 10/24/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251300000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Local Education Agency (LEA) |
| Taxonomy Specialization: | |
| Taxonomy Definition: | The term local education agency means a public board of education or other public authority legally constituted within a State to either provide administrative control or direction of, or perform a service function for public schools serving individuals ages 0 |