Provider Demographics
NPI:1063599116
Name:COMMUNITY MENTAL HEALTH SERVICES INC
Entity type:Organization
Organization Name:COMMUNITY MENTAL HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TEICHMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-365-7000
Mailing Address - Street 1:PO BOX 895
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501
Mailing Address - Country:US
Mailing Address - Phone:715-365-7000
Mailing Address - Fax:715-365-7029
Practice Address - Street 1:1831 N STEVENS STREET
Practice Address - Street 2:
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501
Practice Address - Country:US
Practice Address - Phone:715-365-7000
Practice Address - Fax:715-365-7029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1227261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42131100Medicaid
WI42131100Medicaid