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My Innovative Services
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Green Bay, Wisconsin
NPI 1790067890

My Innovative Services is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Green Bay, WI. My Innovative Services practices in Green Bay, WI. The NPI Number for My Innovative Services is 1790067890 and holds a License No. 320900000X (Wisconsin).

The current practice location address for My Innovative Services is 445 S Madison St, Green Bay, WI and can be reached out via phone at 920-431-0962 and via fax at 920-884-1967.

Location: 445 S Madison St, Green Bay, WI, 54301-4126
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1790067890
Provider Name
My Innovative Services
Credential
Provider Entity Type
Organization
Address
445 S Madison St, Green Bay, WI, 54301-4126
Phone Number
920-431-0962
Fax Number
920-884-1967
Provider Enumeration Date
09/14/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
445 S Madison St
City
Green Bay
State
Wisconsin
Zip
54301-4126
Phone Number
920-431-0962
Fax Number
920-884-1967
person
Provider Business Mailing Address Details
Address
445 S Madison St
City
Green Bay
State
Wisconsin
Zip
54301-4126
Phone Number
920-431-0962
Fax Number
920-884-1967
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
320900000X (Wisconsin)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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