Organization
GREEN VALLEY ENTERPRISES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JEANINE KNUDSON (EXECUTIVE DIRECTOR)
(920) 887-4282
Entity
Organization
Contact information
Practice address
1223 MADISON ST, BEAVER DAM, WI 53916-2629
(920) 887-4282
(920) 887-4292
Mailing address
1223 MADISON ST, BEAVER DAM, WI 53916-2629
(920) 887-4282
(920) 887-4292
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
1387-800
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41421000
—
WI
Enumeration date
03/11/2008
Last updated
03/11/2008
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