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Organization
JACOB'S WELL PRESBYTERIAN CHURCH
Active
Organization
JACOB'S WELL PRESBYTERIAN CHURCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SPENCER REA HANSEN THOMAS LPC, NCC (EXECUTIVE DIRECTOR)
(309) 532-2364
Entity
Organization
Contact information
Practice address
3340 LINEVILLE RD, GREEN BAY, WI 54313-7237
(920) 264-9564
Mailing address
3340 LINEVILLE RD, GREEN BAY, WI 54313-7237
(920) 264-9564
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/14/2021
Last updated
09/14/2021
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