Organization
TREATMENT PROVIDERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADEYEMI OLUDARE FATOKI MD (MEDICAL DIRECTOR/PARTNER)
(920) 770-5061
Entity
Organization
Contact information
Practice address
2731 N PACKERLAND DR STE A, GREEN BAY, WI 54303
(920) 770-5061
(920) 770-5467
Mailing address
2731 N PACKERLAND DR, SUITE A, GREEN BAY, WI 54303-4855
(920) 770-5061
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
03/26/2017
Last updated
12/19/2019
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