NPIMap

Organization Active NPI

Human Services Board Serving North Central Health Care Facility

Doing business as North Central Health Care

  • Psychiatric Hospital
  • Wausau, WI
National Provider Identifier
1306850177
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
HUMAN SERVICES BOARD SERVING NORTH CENTRAL HEALTH CARE FACILITY
Doing business as
North Central Health Care
Practice address
1150 Lake View Dr
Wausau, WI 54403-6785
Phone
(715) 848-4600
Fax
(715) 845-5398
NPI assigned
Jul 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Authorized official

Name
Gary D. Olsen
Title
Executive Director
Phone
(715) 848-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X Primary

Addresses

Primary practice location

1150 Lake View Dr
Wausau, WI 54403-6785

Mailing address

2400 Marshall St Ste a
Wausau, WI 54403-6738
Phone (715) 848-4600

Other identifiers 1

IdentifierTypeStateIssuer
10063700MedicaidWI

Other names 1

  • North Central Health Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101105001145 WI Part A Provider - Hospital 4385617786 1 other NPI on this enrollment
Practice locations: Wausau, WI

Hospital certification: CCN 524017

Legal name
HUMAN SERVICES BOARD SERVING NORTH CENTRAL HEALTH CARE FACILITY
Doing business as
NORTH CENTRAL HEALTH CARE
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Jan 31, 1975
Last certification
Apr 4, 2013
Beds
16
Ownership / control type
Other
Organization structure
GovernmentNon-profit
Enrollment address
1150 Lake View Dr
Wausau, WI 54403-6785
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
North Central Health CareCCN 524017 · All quality measures
Type
Psychiatric
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Human Services Board Serving North Central Heatlh Care Facility31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

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

View all 30

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Human Services Board Serving North Central Health Care Facility Organization, Wausau, WI 5% Or Greater Direct Ownership Interest Jan 31, 1975 100%
Gary Olsen Individual Corporate OfficerExecutive Director Dec 29, 2022 100%
Corporate DirectorExecutive Director Dec 29, 2022 100%
W-2 Managing EmployeeExecutive Director Dec 29, 2022 100%
Jason Hake Individual Corporate DirectorChief Financial Officer Oct 1, 2023
W-2 Managing EmployeeChief Financial Director Oct 1, 2023

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
North Central Health CareWausau, WI, CCN 525132 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1976

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 1

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": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697760000000",
    "number": "1306850177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 MARSHALL ST STE A",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036738",
            "telephone_number": "715-848-4600",
            "fax_number": "715-845-5398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 LAKE VIEW DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036785",
            "telephone_number": "715-848-4600",
            "fax_number": "715-845-5398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMAN SERVICES BOARD SERVING NORTH CENTRAL HEALTH CARE FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-19",
        "status": "A",
        "authorized_official_last_name": "OLSEN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "715-848-4600"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10063700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Central Health Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Central Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.