JACKIE NITSCHKE CENTER, INC.
NPI 1265642318
Substance Abuse Rehabilitation Facility in Green Bay, WI

NPI Status: Active since May 23, 2007

Contact Information

630 CHERRY ST
GREEN BAY, WI
ZIP 54301
Phone: (920) 435-2093

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Authorized Official
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Substance Abuse Rehabilitation Facility
Accepts Insurance
CLIA Number: 52D2117536
CLIA Cert. Type: Other - COMM BASED RES FACILITY
CLIA Exp. Date: 08-17-2026

About JACKIE NITSCHKE CENTER, INC.

This page provides the complete NPI Profile along with additional information for Jackie Nitschke Center, Inc., a provider established in Green Bay, Wisconsin operating as a Substance Abuse Rehabilitation Facility. The healthcare provider is registered in the NPI registry with number 1265642318 assigned on May 2007. The practitioner's primary taxonomy code is 324500000X with license number 1446 (WI). The provider is registered as an organization and their NPI record was last updated 6 years ago. The authorized official of this NPI record is William J. Labine Msw Ics Csac (Executive Director)

NPI: 1265642318
Provider Name: JACKIE NITSCHKE CENTER, INC.
Entity Type: Organization
Location Address: 630 CHERRY ST GREEN BAY, WI 54301
Location Phone: (920) 435-2093
Mailing Address: 630 CHERRY ST GREEN BAY, WI 54301
Mailing Phone: (920) 435-2093
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 05-23-2007
Last Update Date: 08-22-2020
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Substance Abuse Rehabilitation Facility
Taxonomy Code: 324500000X
Type: Residential Treatment Facilities
License No.: 1446
License State: WI
Taxonomy Description: A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Anthem Blue Cross and Blue Shield

Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS

CareSource (Common Ground Healthcare)

CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - EPO
CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - Vision Exam - EPO
CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - EPO
CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - Vision Exam - EPO
CareSource (Common Ground Healthcare) Bronze Standard $7500 - EPO
CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam - EPO
CareSource (Common Ground Healthcare) Gold $0 Ded - EPO
CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam - EPO
CareSource (Common Ground Healthcare) Gold $3300 - EPO
CareSource (Common Ground Healthcare) Gold $3300 - Vision Exam - EPO

Medica

Engage by Medica Bronze HSA - EPO
Engage by Medica Bronze Share - EPO
Engage by Medica Expanded Bronze Standard - EPO
Engage by Medica Gold $0 Copay PCP Visits - EPO
Engage by Medica Gold Share - EPO
Engage by Medica Gold Standard - EPO
Engage by Medica Silver $0 Copay PCP Visits - EPO
Engage by Medica Silver Share - EPO
Engage by Medica Silver Standard - EPO
Essentia Choice Care with Medica Bronze HSA - EPO

Network Health

Prestige Bronze $0 Medical Deductible - HMO
Prestige Bronze $0 Medical Deductible + Dental + Vision - HMO
Prestige Bronze $0 Medical Deductible + Dental +Vision - HMO
Prestige Bronze Essential + 3 Free PCP Visits - HMO
Prestige Bronze Essential + Dental + Vision + 3 Free PCP Visits - HMO
Prestige Bronze Plus - HMO
Prestige Gold - HMO
Prestige Gold 50 + 1 Free PCP Visit - HMO
Prestige Gold 50 + Dental + Vision + 1 Free PCP Visit - HMO
Prestige Gold 50 + Dental + Vision+ 1 Free PCP Visit - HMO

Quartz

QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
QUARTZ GUNDERSEN PERFORMANCE BRONZE $10,150 DED - HMO
QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $10,150 DED - HMO
QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $10,600 DED - HMO
QUARTZ GUNDERSEN PERFORMANCE GOLD $4,000 DED - HMO
QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $4,000 DED - HMO
QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO

Security Health Plan

Enrich $2,000 - 25% - HMO
Enrich $3,500 - 30% - HMO
Enrich $4,000 - 50% - HMO
Enrich $5,000 HDHP - HMO
Enrich $6,000 - 40% - HMO
Enrich $7,500 - HMO
Enrich $7,500 HDHP - HMO
Enrich $9,500 - HMO
Enrich Protection - HMO
Premier $2,000 - 25% - HMO

UnitedHealthcare

UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - HMO
UHC Bronze Standard (No Referrals) - HMO
UHC Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
UHC Gold Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
UHC Gold Standard (No Referrals) - HMO
UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: WILLIAM J. LABINE MSW ICS CSAC
Authorized Official Title: EXECUTIVE DIRECTOR
Authorized Official Phone: (920) 435-2093

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 52D2117536
Facility Type: Other - COMM BASED RES FACILITY
Certificate Effective Date: August 18, 2024
Certificate Expiration Date: August 17, 2026
Laboratory Director: MR. WILLIAM J. LABINE
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to Jackie Nitschke Center, Inc. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1265642318, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 12 → 1 + 2

Pos 4

Unchanged

Pos 5

Doubled → 12 → 1 + 2

Pos 6

Unchanged

Pos 7

Doubled → 4

Pos 8

Unchanged

Pos 9

Doubled → 2

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 6 → 12 → 3 2 → 4 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 2 + 5 + 1 + 2 + 4 + 4 + 3 + 2 + 24 = 52

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 52 is 60. The difference is the calculated check digit.

60 - 52 = 8

This NPI is valid

The calculated check digit is 8, which matches the last digit of 1265642318.