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Organization
OPTIONS FOR INDEPENDENT LIVING
Active
Organization
OPTIONS FOR INDEPENDENT LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHRYN C BARRY M.A. (ASSISTANT DIRECTOR)
(920) 490-8270
Entity
Organization
Contact information
Practice address
555 COUNTRY CLUB RD, GREEN BAY, WI 54313-4908
(920) 490-8270
(920) 490-0700
Mailing address
555 COUNTRY CLUB RD, PO BOX 11967, GREEN BAY, WI 54313-4908
(920) 490-8270
(920) 490-0700
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
100003331
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100003331
—
WI
Enumeration date
02/17/2010
Last updated
02/17/2010
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