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NPI Code Detail

MEDICARE: RACINE COUNTY OPPORTUNITY CENTER, INC.

MEDICARE: RACINE COUNTY OPPORTUNITY CENTER, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251V00000XVoluntary or Charitable Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346380755
Entity Type Code : Organization
Provider Name (Legal Business Name) : RACINE COUNTY OPPORTUNITY CENTER, INC.
Provider Business Mailing Address
First Line : 4214 SHERIDAN RD
Second Line :
City : RACINE
State : WI
Zip : 53403-4142
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4214 SHERIDAN RD
Second Line :
City : RACINE
State : WI
Zip : 53403-4142
Country : US
Telephone Number : 262-554-6515
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : SHERYL ANN HAMILTON
Credential :
Telephone Number : 262-554-6515
Provider Enumeration Date : 02/07/2007
Last Update Date : 01/03/2019

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