Provider Demographics
NPI:1659912319
Name:CORE TREATMENT SERVICES, INC.
Entity type:Organization
Organization Name:CORE TREATMENT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PERSAUD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC CSAC ICS
Authorized Official - Phone:920-663-1035
Mailing Address - Street 1:PO BOX 1823
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54221-1823
Mailing Address - Country:US
Mailing Address - Phone:920-663-1035
Mailing Address - Fax:920-320-1734
Practice Address - Street 1:3 RIVERVIEW DR
Practice Address - Street 2:
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54220-3767
Practice Address - Country:US
Practice Address - Phone:920-645-1411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-03
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100158506Medicaid
WI100158503Medicaid