Provider Demographics
NPI:1518498047
Name:TREATMENT PROVIDERS LLC
Entity Type:Organization
Organization Name:TREATMENT PROVIDERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADEYEMI
Authorized Official - Middle Name:OLUDARE
Authorized Official - Last Name:FATOKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:920-770-5061
Mailing Address - Street 1:2731 N PACKERLAND DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54303-4855
Mailing Address - Country:US
Mailing Address - Phone:920-770-5061
Mailing Address - Fax:
Practice Address - Street 1:2731 N PACKERLAND DR STE A
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54303
Practice Address - Country:US
Practice Address - Phone:920-770-5061
Practice Address - Fax:920-770-5467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-26
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Single Specialty