Healthcare Provider Details

I. General information

NPI: 1649193806
Provider Name (Legal Business Name): BUILT FOR BETTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 DESPLAINE RD
DE PERE WI
54115-3748
US

IV. Provider business mailing address

319 DESPLAINE RD
DE PERE WI
54115-3748
US

V. Phone/Fax

Practice location:
  • Phone: 920-288-9968
  • Fax:
Mailing address:
  • Phone: 920-288-9968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LARRY COLEMAN
Title or Position: CEO
Credential:
Phone: 920-288-9968