Provider Demographics
NPI:1235671728
Name:CENTER POINT COUNSELING SERVICES EMHS
Entity Type:Organization
Organization Name:CENTER POINT COUNSELING SERVICES EMHS
Other - Org Name:CENTER POINT COUNSELING SERVICES COOPERATIVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:GILMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-638-7420
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:VIROQUA
Mailing Address - State:WI
Mailing Address - Zip Code:54665-0189
Mailing Address - Country:US
Mailing Address - Phone:608-638-7420
Mailing Address - Fax:608-638-7429
Practice Address - Street 1:210 AIRPORT RD
Practice Address - Street 2:SUITE 103
Practice Address - City:VIROQUA
Practice Address - State:WI
Practice Address - Zip Code:54665-1160
Practice Address - Country:US
Practice Address - Phone:608-638-7420
Practice Address - Fax:608-638-7429
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTER POINT COUNSELING SERVICES COOPERATIVE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)