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INNOVATIVE WISCONSIN, LLC
NPI 1871972349
Community/Behavioral Health in Green Bay, WI

Active since May 29, 2015
445 S MADISON ST, GREEN BAY, WI 54301(920) 431-0962(920) 884-1967 Get Directions Write a Review

NPPES record last updated: May 29, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Innovative Wisconsin, Llc NPPES

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

INNOVATIVE WISCONSIN, LLC (NPI 1871972349) is a healthcare organization registered as a community/behavioral health in Green Bay, Wisconsin and active in the NPI registry since May 2015. The organization lists Drue Ray, Officer, as its authorized official.

NPPES Registry Identity

NPI1871972349
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameINNOVATIVE WISCONSIN, LLC
Location Address445 S MADISON STGreen Bay, WI 54301-4101
Mailing Address445 S Madison StGreen Bay, WI 54301-4101 · (920) 431-0962 · Fax (920) 884-1967
Phone(920) 431-0962
Fax(920) 884-1967
Organization SubpartYesParent: Innovative Services, Inc.
Authorized OfficialDrue RayOfficer · (828) 684-8441
Enumeration DateMay 29, 2015
✔ NPI 1871972349 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, 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.
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
MY INNOVATIVE SERVICES
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
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 Innovative Wisconsin, LLC's NPI number?

The NPI number for Innovative Wisconsin, LLC is 1871972349. It was assigned to this organization in the NPPES registry on May 29, 2015.

Where is Innovative Wisconsin, LLC located?

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

What is Innovative Wisconsin, LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for Innovative Wisconsin, LLC was last updated on May 29, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.