NPIMap

Organization Active NPI

Gam Behavioral Health Services LLC

  • Adult Mental Health Clinic/Center
  • Green Bay, WI
National Provider Identifier
1033349436
Registry record updated Jan 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
2811 Issued in WI
Legal business name
GAM BEHAVIORAL HEALTH SERVICES LLC
Practice address
3021 Holmgren Way
Suite 203a
Green Bay, WI 54304-6302
Phone
(920) 339-9307
Fax
(920) 339-9374
NPI assigned
Jul 20, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Frank McConnell
Title
Administrator
Phone
(920) 339-9307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 2811 WI Primary

Addresses

Primary practice location

3021 Holmgren Way
Suite 203a
Green Bay, WI 54304-6302

Mailing address

3021 Holmgren Way
Suite 203a
Green Bay, WI 54304-6302
Phone (920) 339-9307

National Provider Directory

National Provider Directory

Locations

3021 Holmgren Way
Ste 203A
Green Bay, WI 54304
Phone (920) 339-9307

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327622400000",
    "number": "1033349436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3021 HOLMGREN WAY",
            "address_2": "SUITE 203A",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543046302",
            "telephone_number": "920-339-9307",
            "fax_number": "920-339-9374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3021 HOLMGREN WAY",
            "address_2": "SUITE 203A",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543046302",
            "telephone_number": "920-339-9307",
            "fax_number": "920-339-9374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAM BEHAVIORAL HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-20",
        "last_updated": "2012-01-27",
        "status": "A",
        "authorized_official_last_name": "MCCONNELL",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "920-339-9307"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "WI",
            "license": "2811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.