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Organization
PH KENOSHA LLC
Active
Organization
PH KENOSHA LLC
Active
Other names
Kenosha Estates Living and Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN KLEIN (MEMBER)
(847) 329-4100
Entity
Organization
Contact information
Practice address
1703 60TH ST, KENOSHA, WI 53140-3986
(262) 658-4125
Mailing address
7444 LONG AVE, SKOKIE, IL 60077-3214
(847) 329-4100
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
02/11/2011
Last updated
02/11/2011
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