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General NPI Number Information
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NPI Number | 1689942989
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Entity Type | Organization
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Legal Business Name | RACINE KENOSHA COMMUNITY ACTION AGENCY
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Dates
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Enumeration Date | 12/01/2011
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Last Update Date | 12/01/2011
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Provider Practice Location Address
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Address Line | 2000 63RD STREET
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City | KENOSHA
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State | WI
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Zip | 53143
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Country | US
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Telephone | 262-657-0840
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Fax | 262-657-1631
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Provider Business Mailing Address
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Address Line | 2113 N WISCONSIN ST
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City | RACINE
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State | WI
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Zip | 53402-4774
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHARON F SCHULZ
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Credential |
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Telephone | 262-637-8377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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