Autism Society of Greater Wisconsin

Organization Active NPI Voluntary or Charitable Agency · Menasha, WI

NPI 1629636873 · NPPES record last updated Jun 3, 2019

Key facts

NPI
1629636873
Entity type
Organization (NPI type 2)
Primary specialty
Voluntary or Charitable Agency 251V00000X
Legal business name
AUTISM SOCIETY OF GREATER WISCONSIN
Practice address
1477 Kenwood Dr Ste 100
Menasha, WI 54952-1160
Phone
(920) 558-4602
Fax
(920) 558-4611
NPI assigned
Jun 3, 2019
Organization subpart
No

Authorized official

Name
Kelly Brodhagen
Title
Office Manager
Phone
(920) 558-4602

National Provider Directory

Locations

1477 Kenwood Dr
Ste 100
Menasha, WI 54952
Phone (920) 558-4602

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Voluntary or Charitable Agency 251V00000X Yes

Addresses

Primary practice location

1477 Kenwood Dr Ste 100
Menasha, WI 54952-1160

Mailing address

1477 Kenwood Dr Ste 100
Menasha, WI 54952-1160
Phone (920) 558-4602

Other names

  • Autism Society of Wisconsin Former legal business name

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address kbrodhagen@autismgreaterwi.org

Other providers in Menasha, WI

All providers in Menasha, WI · Voluntary or Charitable Agency in Wisconsin

Sources for this page

Verify at the official NPI Registry.