NPIMap

Organization Active NPI

Church Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Beaver Dam, WI
National Provider Identifier
1003271180
Registry record updated Dec 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
3106 Issued in WI
Legal business name
CHURCH HEALTH SERVICES
Practice address
115 N Center St
Beaver Dam, WI 53916-2119
Phone
(920) 887-1766
Fax
(920) 887-2322
NPI assigned
Dec 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Susan Osteen
Title
Executive Director
Phone
(920) 887-1766

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 3106 WI Primary

Addresses

Primary practice location

115 N Center St
Beaver Dam, WI 53916-2119

Mailing address

115 N Center St
Beaver Dam, WI 53916-2119
Phone (920) 887-1766

National Provider Directory

National Provider Directory
Tax ID family
Church Health Services Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

115 N Center St
Beaver Dam, WI 53916
Phone (920) 877-1766

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1450224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450224000000",
    "number": "1003271180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 N CENTER ST",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162119",
            "telephone_number": "920-887-1766",
            "fax_number": "920-887-2322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N CENTER ST",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162119",
            "telephone_number": "920-887-1766",
            "fax_number": "920-887-2322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHURCH HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-16",
        "last_updated": "2015-12-16",
        "status": "A",
        "authorized_official_last_name": "OSTEEN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "920-887-1766"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "WI",
            "license": "3106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver Dam, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.