Kenosha Community Health Center, Inc in Kenosha - Federally Qualified Health Center (fqhc)
Kenosha Community Health Center, Inc - NPI 1770789489
Kenosha Community Health Center, Inc is a Federally Qualified Health Center (fqhc) in Kenosha, Wisconsin. Kenosha Community Health Center, Inc practices all healthcare services and medical treatments related to Federally Qualified Health Center (fqhc). The NPI Number for Kenosha Community Health Center, Inc is 1770789489. The last update date is 2022-07-21.
Kenosha Community Health Center, Inc's current location address is 6226 14th Ave, Kenosha, Wisconsin. You can contact this provider via phone number 2629251350 and fax number 2626532218. The mailing address for Kenosha Community Health Center, Inc is 6226 14th Ave, Kenosha, Wisconsin. To know further, please read the information below!
Provider Profile Detail
Provider Organization | Kenosha Community Health Center, Inc |
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Address | 6226 14th Ave, Kenosha, Wisconsin |
Phone Number | 2629251350 |
Fax Number | 2626532218 |
Sole Proprietor | -- |
Credentials | -- |
Authorized Official
Title or Position | EXECUTIVE |
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Authorized Official Name | Waters A Jack |
Telephone Number | 2622372850 |
NPI Number Detail
NPI Number | 1770789489 |
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Provider Enumeration Date | 2007-06-21 |
Last Updated Date | 2022-07-21 |
Provider Mailing Address Detail
Address | 6226 14th Ave |
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City | Kenosha |
State | Wisconsin (WI) |
Post Code | 53143 |
Phone Number | 2629251350 |
Fax Number | 2626532218 |
Provider's Primary Taxonomy Detail
Speciality | Federally Qualified Health Center (fqhc) |
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Taxonomy | 261Qf0400X |
Definition: Provides primary and preventive care services in underserved areas, receiving certain federal funding grants. |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
44014100 | WI | -- | |
32956300 | WI | -- |
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What is the unique 10-digit identifier code assigned to Kenosha Community Health Center, Inc by the Centers for Medicare & Medicaid Services?
The Kenosha Community Health Center, Inc has been issued the NPI (National Provider Identifier) 1770789489 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you share the physical location details of Kenosha Community Health Center, Inc?
The Kenosha Community Health Center, Inc is situated at 6226 14Th Ave, in the city of Kenosha, state of WI, with the zip code 53143.
What is Kenosha Community Health Center, Inc's specialized field of practice, and what is the corresponding taxonomy classification code?
The Kenosha Community Health Center, Inc's area of specialization is Federally Qualified Health Center (fqhc), and the corresponding taxonomy code that categorizes this field of practice is 261Qf0400X.
When did the Kenosha Community Health Center, Inc receive its 1770789489?
The Kenosha Community Health Center, Inc was issued its 1770789489 on 2007-06-21, which is the date when the organization was assigned this unique identifier.
As of what date was the information regarding Kenosha Community Health Center, Inc, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Kenosha Community Health Center, Inc, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2022-07-21.