Organization
RACINE COMMUNITY HEALTH CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RIVA KIMMEL (OPERATIONS MANAGER)
(262) 672-2578
Entity
Organization
Contact information
Practice address
930 DR MARTIN LUTHER KING DR # 17, RACINE, WI 53404-3008
(262) 800-7242
Mailing address
930 DR MARTIN LUTHER KING DR # 17, RACINE, WI 53404-3008
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
10/26/2023
Last updated
10/26/2023
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