Mtc Mental Health Services

LBN: Menominee Indian Tribe Of Wisconsin
Mtc Mental Health Services is an health care organization with primary practice located at W3275 Wolf River Road , Keshena WI 54135. The organization recently has only one registered license in Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), which is considered as the primary health care specialty. Menominee Indian Tribe Of Wisconsin can be contacted via phone (715) 799-3361, or through Waukau, Jerry L via phone (715) 799-3361.

Contact Information

Primary practice address
W3275 Wolf River Road Keshena WI 54135
Phone: (715) 799-3361
Fax: (715) 799-3099
Website:
Map and Directions
Authorized official contact:
Name: Waukau, Jerry L
Phone: (715) 799-3361

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X 1588 Wisconsin

Profile Details

NPI number 1124291802
LBN Legal business name Menominee Indian Tribe Of Wisconsin
DBA Doing business as Mtc Mental Health Services
Authorized official Waukau, Jerry L
Entity Organization
Organization subpart 1 No
Enumeration date Apr 2nd, 2008
Last updated Apr 2nd, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124291802 NPPES
Wisconsin MEDICAID 42173700

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