Kenosha Area Family and Aging Services, Inc.

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

Legal business name

KENOSHA AREA FAMILY AND AGING SERVICES, INC.

Practice address

7730 Sheridan Rd
Kenosha, WI 53143-1518

Phone

(262) 658-3508

Fax

(262) 658-2263

NPI assigned

May 5, 2008

Last updated

May 5, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Gary G Brown

Title

Executive Director

Phone

(262) 658-3508

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1669648242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7730 SHERIDAN RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531431518",
            "telephone_number": "262-658-3508",
            "fax_number": "262-658-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7730 SHERIDAN RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531431518",
            "telephone_number": "262-658-3508",
            "fax_number": "262-658-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENOSHA AREA FAMILY AND AGING SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-05",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "262-658-3508",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44007400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jami Lynn Newcomb Keller
• Madison Kempf, OTR
• Danna Kendall
• Marc V Kennedy, M.D.
• Kenosha Achievement Center
• Kenosha Community Health Center, Inc (Pillar Health)
• Kenosha Community Health Center, Inc (Pillar Health)
• Kenosha Community Health Center, Inc.
• Kenosha County Department of Human Services
• Kenosha County Department of Human Services

• Voluntary or Charitable Agency in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Voluntary or Charitable Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.