Organization
ECUMENICAL HEALTH CENTER
Active
Other names
Autism Resources & Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES PAUL HEIDER ED.S. (LICENSED PSYCHOLOGIST)
(920) 491-9800
Entity
Organization
Contact information
Practice address
1540 CAPITOL DR, SUITE 104, GREEN BAY, WI 54303-2235
(920) 491-9800
(920) 491-9800
Mailing address
1540 CAPITOL DR, SUITE 104, GREEN BAY, WI 54303-2235
(920) 491-9800
(920) 491-9800
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
970057
WI
251S00000X
Community/Behavioral Health Agency
104124
WI
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
104124
WI
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
970057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39081000
—
WI
Enumeration date
08/06/2007
Last updated
08/06/2007
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