Organization
THE SALVATION ARMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L HENRY MSW, CSAC, ICS (PROGRAM ACCOUNTABILITY DIRECTOR)
(414) 302-4300
Entity
Organization
Contact information
Practice address
THE SALVATION ARMY RAY & JOAN KROC CENTER, 1315 LIME KILN ROAD, GREEN BAY, WI 54311
(920) 544-4975
Mailing address
11315 W WATERTOWN PLANK RD, WAUWATOSA, WI 53226-3412
(414) 302-4300
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
102L00000X
Psychoanalyst
—
—
104100000X
Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/24/2019
Last updated
06/24/2019
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