INTEGRATED TREATMENT CENTERS, LLC (NPI# 1215579552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215579552 |
| Entity Type | Organization |
| Organization Name | INTEGRATED TREATMENT CENTERS, LLC |
| Other Organization Name | GREEN BAY INTEGRATED TREATMENT CENTER |
| Practice Address |
2311 W Mason Street Green Bay WI 54303 |
| Mailing Address |
6185 Paseo Del Norte, Ste 150 Carlsbad CA 92011 |
| Practice Telephone | 8555268228 |
| Mailing Telephone | 8552592288 |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2020-05-22 |
| Authorized Official Name | KIM SANDERSON (PRESIDENT, CTC DIVISION) |
| Authorized Official Telephone | 8552592288 |
| Is Organization Subpart | Y |
| Parent Organization Name | ACADIA HEALTHCARE COMPANY, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Other Name | Type Code |
|---|---|
| Green Bay Integrated Treatment Center | Doing Business As Name - Organization |
| Street Address |
2311 W MASON STREET |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
| 1063730042 | Bradley C Heraly | Internal Medicine | 1726 Shawano Avenue, Green Bay Oncology, Green Bay, WI 54303 | 2010-05-14 |
| Find all providers in zip 54303 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043725922 | Healthy Hope Counseling LLC | Community/Behavioral Health | 916 Willard Dr Ste 136, Green Bay, WI 54304-6223 | 2017-12-13 |
| 1801283494 | Abundant Life Counseling & Renewal Center LLC | Community/Behavioral Health | 1221 Bellevue St Ste 113, Green Bay, WI 54302-2155 | 2015-04-21 |
| 1609015569 | Occupational Health Services Inc. | Community/Behavioral Health | 2688 Vissers Ct, Green Bay, WI 54313-5856 | 2009-02-16 |
| 1417107590 | New Hope Counseling Center of Wi, Inc. | Community/Behavioral Health | 3021 Holmgren Way, #203, Green Bay, WI 54304-6302 | 2008-09-24 |
| 1699948471 | Robyn Rickert & Associates, LLC | Community/Behavioral Health | 130 E Walnut St Ste 406, Green Bay, WI 54301-4231 | 2008-04-11 |
| 1093869588 | Innovative Counseling Inc | Community/Behavioral Health | 1499 6th St, Innovative Counseling Inc, Green Bay, WI 54304-2252 | 2007-01-22 |
| 1497818454 | Christian Counseling Ministries, Inc. | Community/Behavioral Health | 2150 Memorial Dr, Suite #213, Green Bay, WI 54303-6335 | 2006-12-19 |
| 1063985620 | Mamma Gese | Community/Behavioral Health | 217 N Madison St Ste 4, Green Bay, WI 54301-5103 | 2019-01-07 |
| 1598117822 | Generations Community Services | Community/Behavioral Health | 217 N Madison St, Suite 5, Green Bay, WI 54301-5103 | 2016-07-11 |
| 1871972349 | Innovative Wisconsin, LLC | Community/Behavioral Health | 445 S Madison St, Green Bay, WI 54301-4101 | 2015-05-29 |
| Find all providers in GREEN BAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.