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General NPI Number Information
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NPI Number | 1386713352
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Entity Type | Organization
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Legal Business Name | COUNTY OF BROWN
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 3150 GERSHWIN DRIVE
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City | GREEN BAY
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State | WI
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Zip | 54311-5859
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Country | US
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Telephone | 920-391-6940
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Fax | 920-391-4731
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Provider Business Mailing Address
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Address Line | 3150 GERSHWIN DRIVE
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City | GREEN BAY
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State | WI
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Zip | 54311-5859
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Country | US
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Telephone | 920-391-6940
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Fax | 920-391-4870
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Authorized Official
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Title or Position | BEHAVIORAL HEALTH MANAGER
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Name | ELIZA KILLIAN
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Credential |
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Telephone | 920-391-4816
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2615
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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