| NPI | 1942595657 |
|---|---|
| Doing Business As | KENOSHA COMMUNITY CENTER CLINIC |
| Entity Type | Organization |
| Authorized Contact | MARY COFFEY Executive Director 262-764-3608 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2014-07-23 |