Organization
FAMILY SERVICES OF NORTHEAST WI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS E MARTIN (PRESIDENT)
(920) 436-6800
Entity
Organization
Contact information
Practice address
1822 RIVERSIDE DR, GREEN BAY, WI 54301-2317
(920) 436-4416
Mailing address
300 CROOKS ST, PO BOX 22308, GREEN BAY, WI 54301-4527
(920) 436-6800
(920) 437-3540
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44018500
—
WI
Enumeration date
04/07/2008
Last updated
04/07/2008
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