Organization
BELL THERAPY KENOSHA COMMUNITY SUPPORT PROGRAM
Active
Other names
Bell Therapy CSP Kenosha
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE JONES M.S. (DIRECTOR OF OUTPATIENT SERVICES)
(414) 871-6122
Entity
Organization
Contact information
Practice address
5500 8TH AVE, KENOSHA, WI 53140-3700
(262) 564-0067
Mailing address
5500 8TH AVE, KENOSHA, WI 53140-3700
(262) 564-0067
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
2409
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2409
STATE CERTIFICATE-LICENSE
WI
05
—
43431100
—
WI
Enumeration date
06/22/2007
Last updated
08/22/2020
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