Organization
KENOSHA HUMAN DEVELOPMENT SERVICES, INC
Active
Other names
Kenosha Youth Development Services, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNINE MARIE FIELD (EXECUTIVE DIRECTOR)
(262) 764-8555
Entity
Organization
Contact information
Practice address
3536 52ND ST, KENOSHA, WI 53144-2662
(262) 842-0538
(262) 842-0539
Mailing address
3536 52ND ST, KENOSHA, WI 53144-2662
(262) 842-0538
(262) 842-0539
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32975970
—
WI
Enumeration date
03/10/2008
Last updated
09/06/2022
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