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General NPI Number Information
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NPI Number | 1467332486
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Entity Type | Organization
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Legal Business Name | EMPLIFY HEALTH BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 301 E SAINT JOSEPH ST
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City | GREEN BAY
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State | WI
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Zip | 54301-2241
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Country | US
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Telephone | 920-433-6073
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Fax |
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Provider Business Mailing Address
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Address Line | 744 S WEBSTER AVE
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City | GREEN BAY
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State | WI
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Zip | 54301-3505
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | ABBY JULIA ENGEBOSE
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Credential |
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Telephone | 920-433-7860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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