OrganizationActive
Menominee Indian Tribe of Wisconsin
NPI 1124291802 · Mental Health Clinic/Center (Including Community Mental Health Center) · Keshena, WI
Provider details
- NPI number
- 1124291802
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jerry Waukau, Health Administrator(715) 799-3361
- License
- 1588 (WI)
Specialties & taxonomies
- Mental Health Clinic/Center (Including Community Mental Health Center)Primary261QM0801XLicense 1588 (WI)
Ambulatory Health Care Facilities
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
W3275 Wolf River Road
Keshena, WI 54135
Phone: (715) 799-3361
Fax: (715) 799-3099
Street-level locationGet directions
Mailing address
Po Box 970
Keshena, WI 54135-0970
Other names (DBA / former)
- Doing business as
- Mtc Mental Health Services
Registry dates
- Enumerated
- 2008-04-02
- Last updated
- 2008-04-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.