| Brown County Community Treatment Center - Ccs Non Billing | |
|
3150 Gershwin Drive Green Bay WI 54311-5859 | |
| (920) 391-4839 | |
| (920) 391-4870 |
| Full Name | Brown County Community Treatment Center - Ccs Non Billing |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3150 Gershwin Drive, Green Bay, Wisconsin |
| Authorized Official Name and Position | Kevin Lunog (CLINICAL SUPPORT SERVICE COOR) |
| Authorized Official Contact | 9203916959 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brown County Community Treatment Center - Ccs Non Billing 3150 Gershwin Drive Green Bay WI 54311-5859 Ph: (920) 391-4839 | Brown County Community Treatment Center - Ccs Non Billing 3150 Gershwin Drive Green Bay WI 54311-5859 Ph: (920) 391-4839 |
| NPI Number | 1396811204 |
|---|---|
| Provider Enumeration Date | 11/24/2006 |
| Last Update Date | 02/11/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396811204 | NPI | - | NPPES |
| 41761700 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2615 (Wisconsin) | Primary |
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