CCS Provider Application

Please use the following documents below to complete your CCS Provider Application with North Central Health Care.

CCS Provider Application (Fillable Word Document)

CCS Provider Rate Setting (.xlsx Excel Document)

Vendor Direct Deposit Authorization (Fillable Word Document)

Need additional assistance with CCS Provider Rate Setting? Watch this helpful video: Overview of the CCS Provider Rate Setting Tool

Upon completion, please submit your finished documentation to:
North Central Health Care
C/O Community Treatment Quality Assurance Specialist
1100 Lake View Drive
Wausau, WI 54403
OR
Submit electronically to CCSContracts@norcen.org

If you have any questions, please contact NCHC Community Treatment at 715.843.6120.