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Organization
FAMILY SERVICES OF NORTHEAST WISCONSIN INC
Active
Organization
FAMILY SERVICES OF NORTHEAST WISCONSIN INC
Active
Other names
Family Services of NEW
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS E MARTIN LCSW (PRESIDENT / CEO)
(920) 436-6800
Entity
Organization
Contact information
Practice address
1810 APPLETON RD, MENASHA, WI 54952-1110
(920) 739-4226
(920) 739-7639
Mailing address
1810 APPLETON RD, MENASHA, WI 54952-1110
(920) 739-4226
(920) 739-7639
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
1333
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42222600
—
WI
Enumeration date
08/18/2005
Last updated
06/04/2009
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