| Bh Ccs | |
|
111 W Jackson St Wisconsin Rapids WI 54495-2702 | |
| (715) 421-8800 | |
| (715) 421-2266 |
| Full Name | Bh Ccs |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 111 W Jackson St, Wisconsin Rapids, Wisconsin |
| Authorized Official Name and Position | Brandon Vruwink (DIRECTOR OF HUMAN SERVICES) |
| Authorized Official Contact | 7154218800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bh Ccs 2611 12th St S Wisconsin Rapids WI 54494-6445 Ph: (715) 421-8800 | Bh Ccs 111 W Jackson St Wisconsin Rapids WI 54495-2702 Ph: (715) 421-8800 |
| NPI Number | 1902021504 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 09/09/2022 |
| Certification Date | 09/09/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902021504 | NPI | - | NPPES |
| 41763200 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2019 (Wisconsin) | Primary |
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