| NPI | 1184354979 |
|---|---|
| Doing Business As | KENOSHA COMPREHENSIVE TREATMENT CENTER |
| Entity Type | Organization |
| Authorized Contact | BRIAN PHILLIP FARLEY VP & Secretary 156-716-9335 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2022-06-14 |
| Last Update Date | 2023-12-06 |