INNOVATIVE WISCONSIN, LLC

GREEN BAY, WI
NPI1871972349
Entity TypeOrganization
Authorized ContactDRUE RAY
Officer
828-684-8441
Organization Subpart ?Yes
Primary Taxonomy251S00000X Community/Behavioral Health
Enumeration Date2015-05-29
Last Update Date2015-05-29
Business Address
INNOVATIVE WISCONSIN, LLC
445 S MADISON ST
GREEN BAY, WI 54301-4101
Phone number: 920-431-0962
Mailing Address
INNOVATIVE WISCONSIN, LLC
445 S MADISON ST
GREEN BAY, WI 54301-4101
Phone number: 920-431-0962
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