KENOSHA COMMUNITY HEALTH CENTER, INC.; NPI #1265435960

Contact Information

KENOSHA COMMUNITY HEALTH CENTER, INC.

4536 22ND AVE
KENOSHA, WI 53140-5917

Phone: 262-656-0044
Fax: 262-653-2218
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Federally Qualified Health Center (FQHC)	261QF0400X	B4[14]	Federally Qualified Health Center
Child & Adolescent Psychiatry	2084P0804X	86	Physician/Neuropsychiatry
Clinical	1041C0700X	80	Licensed Clinical Social Worker
Counselor	101Y00000X
Dentist	122300000X
Family Medicine	207Q00000X	08	Physician/Family Practice
General Practice	208D00000X	99	Physician/Undefined Physician type[6]
Mental Health	101YM0800X
Professional	101YP2500X
Psychiatric/Mental Health	363LP0808X	50	Nurse Practitioner
Psychiatry	2084P0800X	26	Physician/Psychiatry

Indicates primary specialty

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NPI Profile & details for KENOSHA COMMUNITY HEALTH CENTER, INC.

NPI # 1265435960

LBN Legal business name KENOSHA COMMUNITY HEALTH CENTER, INC.

Authorized official MARY OUIMET - (CEO)

Entity Organization

Organization subpart ¹ No

Enumeration date 05/27/2005

Last updated 02/25/2026 - About 3 months ago

Identifiers

WI	License #	NONE
WI	Medicaid	32956300

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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KENOSHA COMMUNITY HEALTH CENTER, INC.

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NPI Profile & details for KENOSHA COMMUNITY HEALTH CENTER, INC.

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