| Kenosha Community Health Center, Inc. | |
|
2310 Center St Racine WI 53403-3330 | |
| (262) 764-3608 | |
| (262) 764-3636 |
| Full Name | Kenosha Community Health Center, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 2310 Center St, Racine, Wisconsin |
| Authorized Official Name and Position | Mary S Mchugh-coffey (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2627643608 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenosha Community Health Center, Inc. 625 57th St Suite 700 Kenosha WI 53140-4146 Ph: (262) 764-3608 | Kenosha Community Health Center, Inc. 2310 Center St Racine WI 53403-3330 Ph: (262) 764-3608 |
| NPI Number | 1174071658 |
|---|---|
| Provider Enumeration Date | 09/14/2016 |
| Last Update Date | 09/14/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174071658 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Wisconsin) | Primary |
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