Provider Demographics
NPI:1467168898
Name:CGH HOLDINGS LLC
Entity Type:Organization
Organization Name:CGH HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONWER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAUPT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:715-559-7693
Mailing Address - Street 1:1707 HILLSDALE RD
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54703-2537
Mailing Address - Country:US
Mailing Address - Phone:715-559-7693
Mailing Address - Fax:
Practice Address - Street 1:1707 HILLSDALE RD
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54703-2537
Practice Address - Country:US
Practice Address - Phone:715-559-7693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)