Healthcare Provider Details

I. General information

NPI: 1194814335
Provider Name (Legal Business Name): KENOSHA COUNTY SCOUT LEADERS RESCUE SQUAD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3019 45TH ST
KENOSHA WI
53144-1647
US

IV. Provider business mailing address

3019 45TH ST
KENOSHA WI
53144-1647
US

V. Phone/Fax

Practice location:
  • Phone: 262-652-2041
  • Fax:
Mailing address:
  • Phone: 262-652-2041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number6000282
License Number StateWI

VIII. Authorized Official

Name: MR. MICHAEL L KURHAJEC
Title or Position: ASSISTANT CHIEF - BOARD PRESIDENT
Credential: EMT
Phone: 262-652-2041