Organization
BROWN COUNTY HEALTH CARE CENTER BAYVIEW DEVELPMENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANE PIVONKA RN, MS, APNP, NHA (INPATIENT SERVICES DIRECTOR)
(920) 391-4700
Entity
Organization
Contact information
Practice address
2900 SAINT ANTHONY DR, GREEN BAY, WI 54311-5859
(920) 391-4700
(920) 391-4870
Mailing address
2900 SAINT ANTHONY DR, GREEN BAY, WI 54311-5859
(920) 391-4700
(920) 391-4870
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
2986
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21050800
—
WI
Enumeration date
09/13/2006
Last updated
08/22/2020
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