Organization
KENOSHA COMMUNITY HEALTH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN STAMPFL (CFO)
(262) 771-3561
Entity
Organization
Contact information
Practice address
903 S 2ND ST, SILVER LAKE, WI 53170-1747
(262) 656-0044
Mailing address
4006 WASHINGTON RD, KENOSHA, WI 53144-4819
(262) 656-0044
(262) 649-1944
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
11/19/2018
Last updated
02/25/2026
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