Kenosha Community Health Center, Inc.

NPI 1265435960 - Family Medicine - 207Q00000X

NPI Details
NPI 1265435960
Enumeration Date 05/27/2005
Last Updated 09/09/2014
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name MARY MARY
Position EXECUTIVE DIRECTOR
Phone (262) 656-0044
Fax (262) 653-2218
Practice Location
4536 22ND AVE
KENOSHA WI, 53140-5917, US
Phone (262) 656-0044
Fax (262) 653-2218
Business Location
625 57TH ST
SUITE 700
KENOSHA WI, 53140-4146, US
Phone (262) 764-3622
Fax (262) 764-3636
Toxanomy
Taxonomy Code 207Q00000X
License State
License Number
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According to our database, Kenosha Community Health Center, Inc. NPI is 1265435960, taxonomy code is 207Q00000X Kenosha Community Health Center, Inc. physically located at 4536 22nd Ave, Kenosha WI, 53140-5917. NPI Number 1033115704 has the healthcare provider type.

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1265435960 NPI number is provided on an as is basis without warranty of any kind. 1265435960 is maintained by the National Plan & Provider Enumeration System. The contents of Kenosha Community Health Center, Inc. are for informational purposes only.