Kenosha Community Health Center, Inc.
LBN: Kenosha Community Health Center, Inc.
Kenosha Community Health Center, Inc. is an health care organization with primary practice located at 4536 22Nd Ave , Kenosha WI 53140-5917. The organization recently has 3 registered licenses in different health care specialties including Dental Providers / Dentist, Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Community Health. Ambulatory Health Care Facilities / Community Health is the primary health care specialty.
Kenosha Community Health Center, Inc. can be contacted via phone (262) 656-0044, or through Coffey, Mary via phone (262) 764-3608.
Contact Information
Primary practice address
4536 22Nd Ave
Kenosha WI 53140-5917
Phone: (262) 656-0044
Fax: (262) 653-2218
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | ||
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Ambulatory Health Care Facilities / Community Health | 261QC1500X | NONE | Wisconsin |
Profile Details
| NPI number | 1265435960 |
|---|---|
| LBN Legal business name | Kenosha Community Health Center, Inc. |
| DBA Doing business as | |
| Authorized official | Coffey, Mary |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 27th, 2005 |
| Last updated | Sep 9th, 2014 - about 10 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265435960 | NPPES |
| Wisconsin | MEDICAID | 32956300 |
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