Organization
JACKIE NITSCHKE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM J. LABINE MSW ICS CSAC (EXECUTIVE DIRECTOR)
(920) 435-2093
Entity
Organization
Contact information
Practice address
630 CHERRY ST, GREEN BAY, WI 54301-4931
(920) 435-2093
Mailing address
630 CHERRY ST, GREEN BAY, WI 54301-4931
(920) 435-2093
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
1446
WI
Other
Enumeration date
05/23/2007
Last updated
08/22/2020
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