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General NPI Number Information
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NPI Number | 1710825575
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Entity Type | Organization
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Legal Business Name | ETERNAL FOCUS CHRISTIAN COUNSELING LLC
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Dates
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Enumeration Date | 03/23/2026
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Last Update Date | 03/23/2026
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Provider Practice Location Address
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Address Line | W6751 SHAYLEE TRL
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City | GREENVILLE
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State | WI
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Zip | 54942-7804
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Country | US
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Telephone | 410-210-6967
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Fax |
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Provider Business Mailing Address
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Address Line | 4764 W INTEGRITY WAY # 146
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City | APPLETON
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State | WI
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Zip | 54913-8464
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Country | US
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Telephone | 405-210-6967
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Fax |
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Authorized Official
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Title or Position | OWNER/COUNSELOR
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Name | AMY POLZIN
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Credential |
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Telephone | 405-210-6967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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