Organization
FAMILY SERVICES OF NORTHEAST WISCONSIN, INC.
Active
Other names
Family Services - Residential Treatment
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS MARTIN (PRESIDENT-CEO)
(920) 436-6800
Entity
Organization
Contact information
Practice address
3430 SPIRIT WAY, GREEN BAY, WI 54304-5687
(920) 330-0339
(920) 330-9060
Mailing address
300 CROOKS ST, GREEN BAY, WI 54301-4527
(920) 436-6800
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
1005260
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43016200
—
WI
Enumeration date
03/23/2007
Last updated
08/22/2020
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