MY INNOVATIVE SERVICES
NPI 1790067890
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Green Bay, WI

Q: What is My Innovative Services's NPI number?

The NPI number for My Innovative Services is 1790067890. It was assigned to this organization in the NPPES registry on September 14, 2011.

Q: What is My Innovative Services's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

Active since September 14, 2011

445 S MADISON ST, GREEN BAY, WI 54301(920) 431-0962(920) 884-1967 Get Directions Write a Review

NPPES record last updated: September 14, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About My Innovative Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MY INNOVATIVE SERVICES (NPI 1790067890) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Green Bay, Wisconsin and active in the NPI registry since September 2011. The organization lists Marsha Renee Burklund, Controller, as its authorized official.

NPPES Registry Identity

NPI1790067890

Entity TypeOrganization

Primary Taxonomy320900000X

Legal Business NameMY INNOVATIVE SERVICES

Location Address445 S MADISON STGreen Bay, WI 54301-4126

Mailing Address445 S Madison StGreen Bay, WI 54301-4126 · (920) 431-0962 · Fax (920) 884-1967

Phone(920) 431-0962

Fax(920) 884-1967

Organization SubpartNo

Authorized OfficialMarsha Renee BurklundController · (920) 431-0962

Enumeration DateSeptember 14, 2011

✔ NPI 1790067890 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities

Taxonomy Code320900000X

License✔ Licensed in WI · 320900000X

Definition

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

445 S MADISON ST, Green Bay, WI 54301

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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

INNOVATIVE SERVICES, INC.

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

445 S MADISON ST
GREEN BAY, WI 54301

Brown County (920) 431-0962

INNOVATIVE WISCONSIN, LLC

Community/Behavioral Health

445 S MADISON ST
GREEN BAY, WI 54301

Brown County (920) 431-0962

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is My Innovative Services's NPI number?

The NPI number for My Innovative Services is 1790067890. It was assigned to this organization in the NPPES registry on September 14, 2011.

Where is My Innovative Services located?

My Innovative Services is located at 445 S Madison St, Green Bay, WI 54301. The listed phone number is (920) 431-0962.

What is My Innovative Services's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

When was this NPI record last updated?

The NPPES record for My Innovative Services was last updated on September 14, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.