Hunters Haven of Kenosha, LLC

NPI #1265601389 in Kenosha, Wisconsin

Provider Information

NPI Number: 1265601389
Entity Type: Organization
Organization Name: Hunters Haven of Kenosha, LLC
Primary Specialty: Residential Treatment Facility, Physical Disabilities
Enumeration Date: Feb 22, 2008
Last Updated: Feb 22, 2008

Practice Location

Address: 5500 41ST ST
City: Kenosha
State: Wisconsin
ZIP Code: 53144-1839
Phone: (262) 656-1934

Authorized Official

Name: MS. BRENDA YVETTE HUNTER
Title: PRESIDENT/OWNER/OPERATOR
Phone: (262) 656-1934

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Physical Disabilities	320700000X	Primary

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