| Amery Hospital & Clinic - Behavioral Health Center | |
|
230 Deronda St Amery WI 54001-1412 | |
| (715) 268-8000 | |
| (715) 268-0071 |
| Full Name | Amery Hospital & Clinic - Behavioral Health Center |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 230 Deronda St, Amery, Wisconsin |
| Authorized Official Name and Position | Debra A Rudquist (PRESIDENT/CEO) |
| Authorized Official Contact | 7152688000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amery Hospital & Clinic - Behavioral Health Center 265 Griffin St E Amery WI 54001-1439 Ph: (715) 268-8000 | Amery Hospital & Clinic - Behavioral Health Center 230 Deronda St Amery WI 54001-1412 Ph: (715) 268-8000 |
| NPI Number | 1699003202 |
|---|---|
| Provider Enumeration Date | 11/20/2009 |
| Last Update Date | 02/18/2015 |
| Medicare PECOS PAC ID | 2769391960 |
|---|---|
| Medicare Enrollment ID | O20080929000736 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699003202 | NPI | - | NPPES |
| 528516 | Other | WI | RURAL HEALTH CLINIC LUCK CLINIC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 528516 RHC (Wisconsin) | Secondary |
| 273R00000X | Psychiatric Unit | 1069 (Wisconsin) | Primary |
| Provider Name | Anne C Dibala |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487614301 PECOS PAC ID: 3971539644 Enrollment ID: I20170426001771 |
| Provider Name | Tara L Thiele |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720625049 PECOS PAC ID: 0749623007 Enrollment ID: I20240205000346 |
Northwest Journey - Amery Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1096 Apple Ave, Amery, WI 54001 Phone: 715-268-5404 Fax: 715-268-6103 | |
Inner Peak Counseling And Consulting Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 203 Riverside Blvd, Amery, WI 54001 Phone: 715-944-2776 | |
Aspen Guardian Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 Maple St E, Amery, WI 54001 Phone: 715-497-2433 Fax: 715-268-2433 |