KENOSHA COMMUNITY HEALTH CENTER INC is a community health clinic center in Kenosha, WI. KENOSHA COMMUNITY HEALTH CENTER INC NPI is 1265435960. The provider is registered as an organization entity type and is a multi-specialty group.
The provider's business location address is:
4536 22ND AVE
KENOSHA, WI
ZIP 53140
Phone: (262) 656-0044
Fax: (262) 653-2218
The provider's authorized official is Jack A Waters .
The authorized official title is Executive Director and has the following contact phone number (262) 237-2850.
The CLIA number assigned to this NPI record is 52D0909220 - federally qualified health center with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 5/27/2005 and was last updated on 7/28/2008.