Provider Demographics
NPI:1548826159
Name:CENTER FOR CHILDHOOD SAFETY
Entity type:Organization
Organization Name:CENTER FOR CHILDHOOD SAFETY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-272-0111
Mailing Address - Street 1:842 S MILITARY AVE
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54304-2114
Mailing Address - Country:US
Mailing Address - Phone:920-272-0110
Mailing Address - Fax:
Practice Address - Street 1:842 S MILITARY AVE
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54304-2114
Practice Address - Country:US
Practice Address - Phone:920-272-0110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
No251V00000XAgenciesVoluntary or Charitable