Provider Demographics
NPI:1194891739
Name:COMMUNITY HEALTH PARTNERSHIP
Entity type:Organization
Organization Name:COMMUNITY HEALTH PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BULLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-838-2901
Mailing Address - Street 1:2240 EASTRIDGE CENTER
Mailing Address - Street 2:
Mailing Address - City:EAU CLARIE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-3410
Mailing Address - Country:US
Mailing Address - Phone:715-838-2900
Mailing Address - Fax:715-838-2910
Practice Address - Street 1:2240 EASTRIDGE CENTER
Practice Address - Street 2:
Practice Address - City:EAU CLARIE
Practice Address - State:WI
Practice Address - Zip Code:54701-3410
Practice Address - Country:US
Practice Address - Phone:715-838-2900
Practice Address - Fax:715-838-2910
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARTNERSHIP HEALTH PLAN, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-27
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care