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Organization

ADVOCATES FOR HEALTHY TRANSITIONAL LIVING, LLC

Active
Other names
Foster Care Academy
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DANIEL ROBERT HOLSTEAD LCSW (DIRECTOR)
(920) 634-6162
Entity
Organization

Contact information

Practice address
3021 HOLMGREN WAY, SUITE 203, GREEN BAY, WI 54304-6302
(920) 634-6162
(920) 339-9374
Mailing address
3021 HOLMGREN WAY, SUITE 203, GREEN BAY, WI 54304-6302
(920) 634-6162
(920) 339-9374

Taxonomy

Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
8038182
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39761600
WI
Enumeration date
12/07/2011
Last updated
12/07/2011
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