Organization
COUNTY OF BROWN
Active
Parent organization
COUNTY OF BROWN
Other names
Brown County Community Treatment Center-Nicolet Psych
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTY OF BROWN
Authorized official
KARA GRUBER (ADMINISTRATOR)
(920) 391-4700
Entity
Organization
Contact information
Practice address
3150 GERSHWIN DRIVE, GREEN BAY, WI 54311-5859
(920) 391-4700
(920) 391-4870
Mailing address
3150 GERSHWIN DRIVE, GREEN BAY, WI 54311-5859
(920) 391-4700
(920) 391-4870
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
213
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10064500
—
WI
01
—
510142673043
BLUE CROSS
WI
01
—
CC6458
RAILROAD MEDICARE
WI
Enumeration date
08/31/2006
Last updated
05/10/2024
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