| Organization Name: | CHURCH HEALTH SERVICES |
| NPI Number: | 1003271180 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUSAN OSTEEN (EXECUTIVE DIRECTOR) |
| Mailing Address: | 115 N Center St Beaver Dam |
| State: | WI US |
| Postal Code: | 539162119 |
| Phone Number: | 9208871766 |
| Fax Number: | 9208872322 |
| NPI Enumeration Date: | 12/16/2015 |
| NPI Last Update Date: | 12/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0801X |
| License Number: | 3106 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
| Taxonomy Definition: | |