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General NPI Number Information
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NPI Number | 1649346990
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Entity Type | Organization
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Legal Business Name | GOODWILL INDUSTRIES OF NORTH CENTRAL WISCONSIN INC
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1800 APPLETON ROAD
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City | MENASHA
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State | WI
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Zip | 54952
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Country | US
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Telephone | 920-731-6601
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Fax | 920-968-6977
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Provider Business Mailing Address
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Address Line | 1800 APPLETON ROAD
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City | MENASHA
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State | WI
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Zip | 54952
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Country | US
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Telephone | 920-731-6601
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Fax | 920-968-6977
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Authorized Official
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Title or Position | CFO
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Name | STEPHEN A WHITE
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Credential |
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Telephone | 920-731-6601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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