| Thedacare Behavioral Health | |
|
1095 Midway Rd Menasha WI 54952-1115 | |
| (920) 720-2300 | |
| Not Available |
| Full Name | Thedacare Behavioral Health |
|---|---|
| Speciality | Counselor |
| Location | 1095 Midway Rd, Menasha, Wisconsin |
| Authorized Official Name and Position | William Flett (CFO) |
| Authorized Official Contact | 9204544013 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thedacare Behavioral Health 3 Neenah Ctr Neenah WI 54956-3070 Ph: (920) 830-5900 | Thedacare Behavioral Health 1095 Midway Rd Menasha WI 54952-1115 Ph: (920) 720-2300 |
| NPI Number | 1306959515 |
|---|---|
| Provider Enumeration Date | 08/15/2006 |
| Last Update Date | 01/02/2024 |
| Certification Date | 01/02/2024 |
| Medicare PECOS PAC ID | 1759294887 |
|---|---|
| Medicare Enrollment ID | O20171115001174 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306959515 | NPI | - | NPPES |
| 42185300 | Medicaid | WI | |
| 42186500 | Medicaid | WI | |
| 42213400 | Medicaid | WI | |
| 21277600 | Medicaid | WI | |
| 42189600 | Medicaid | WI |
| Provider Name | John Thomas Beld |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144397845 PECOS PAC ID: 3577526029 Enrollment ID: I20160411001333 |
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