WEST SIDE COMMUNITY HEALTH SERVICES, INC. (NPI# 1649394727) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1649394727 |
Entity Type | Organization |
Organization Name | WEST SIDE COMMUNITY HEALTH SERVICES, INC. |
Other Organization Name | HUMBOLDT JR SR HIGHSCHOOL CLINIC |
Practice Address |
30 Baker St E Saint Paul MN 55107-2966 |
Mailing Address |
153 Cesar Chavez St Saint Paul MN 55107-2226 |
Practice Telephone | 6513121996 |
Practice Fax Number | 6513121997 |
Mailing Telephone | 6512221816 |
Mailing Fax Number | 6512221305 |
Enumeration Date | 2007-03-16 |
Last Update Date | 2008-06-18 |
Authorized Official Name | MAVIS CAROL BREHM (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 6516027536 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
MN | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | 522927000 | 05 |
Other Name | Type Code |
---|---|
Humboldt Jr Sr HighSchool Clinic | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932392727 | West Side Community Health Services, Inc. | Clinic/Center | 740 Rose Ave W, Saint Paul, MN 55117-4042 | 2007-08-24 |
1023201811 | West Side Community Health Services, Inc. | Clinic/Center | 275 Lexington Pkwy N, Saint Paul, MN 55104-5402 | 2007-08-24 |
1881887032 | West Side Community Health Services, Inc. | Clinic/Center | 1540 6th St E, Saint Paul, MN 55106-4806 | 2007-08-21 |
1407049653 | West Side Community Health Services, Inc. | Clinic/Center | 1015 Snelling Ave S, Saint Paul, MN 55116-2447 | 2007-08-21 |
1881718971 | West Side Community Health Services, Inc. | Clinic/Center | 980 9th Ave S, Saint Paul Park, MN 55071-1436 | 2007-03-16 |
1457475543 | West Side Community Health Services, Inc. | Clinic/Center | 495 Rice Street, St Paul, MN 55117-3864 | 2007-03-16 |
1730203944 | West Side Community Health Services, Inc. | Clinic/Center | 2001 Van Dyke St, Maplewood, MN 55109-3711 | 2007-03-16 |
1083765135 | West Side Community Health Services, Inc. | Clinic/Center | 1349 Arcade St, Saint Paul, MN 55106-1801 | 2007-01-16 |
1821149964 | West Side Community Health Services, Inc. | Clinic/Center | 1544 Timberlake Rd, Saint Paul, MN 55117-3946 | 2007-01-16 |
1104977255 | West Side Community Health Services, Inc. | Clinic/Center | 435 University Ave E, Saint Paul, MN 55101-4437 | 2007-01-16 |
Street Address |
30 BAKER ST E |
City | SAINT PAUL |
State | MN |
Zip Code | 55107-2966 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477944809 | Marina Castillo | Counselor | 143 Isabel St. W, Saint Paul, MN 55107 | 2015-02-06 |
1134540123 | Michelle M Lee | Social Worker | 106 Water Street/3rd Floor, Umbrella Tree Studios, St. Paul, MN 55107 | 2013-12-18 |
1376748574 | Mary E. A. Horoshak | Physical Therapist | 155 S Wabasha St, Suite 130, St. Paul, MN 55107 | 2007-06-18 |
1821156050 | Amherst H. Wilder Foundation | Assisted Living Facility | 469 Ada St, Saint Paul, MN 55107 | 2006-12-04 |
1407914674 | Amherst H. Wilder Foundation | Clinic/Center | 516 Humboldt Ave, Saint Paul, MN 55107 | 2006-12-04 |
1780753681 | Chad Randal Vickers | Nurse Practitioner | 135 Colorado Street East, Saint Paul, MN 55107 | 2006-11-06 |
1225122872 | Elizabeth E Frost | Family Medicine | 153 Cesar Chavez Street, St Paul, MN 55107 | 2006-10-03 |
1215457890 | Elizabeth Smith Zaremba | Dietitian, Registered | 205 Wabasha St S, Mail Stop 31300a, St Paul, MN 55107 | 2017-06-23 |
1619413606 | Elizabeth Burgos | Social Worker | 153 Cesar Chavez St, Saint Paul, MN 55107 | 2017-01-13 |
1033561915 | Isetta Pierre | Marriage & Family Therapist | 153 Cesar Chavez St, Saint Paul, MN 55107 | 2016-07-05 |
Find all providers in zip 55107 |
Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205397395 | Health Start Sbc Creative Arts | Clinic/Center | 65 Kellogg Blvd E, Saint Paul, MN 55101-1106 | 2019-03-29 |
1194902072 | West Side Community Health Services, Inc | Clinic/Center | 1212 University Ave W, Saint Paul, MN 55104-4123 | 2008-01-23 |
1932392727 | West Side Community Health Services, Inc. | Clinic/Center | 740 Rose Ave W, Saint Paul, MN 55117-4042 | 2007-08-24 |
1023201811 | West Side Community Health Services, Inc. | Clinic/Center | 275 Lexington Pkwy N, Saint Paul, MN 55104-5402 | 2007-08-24 |
1881887032 | West Side Community Health Services, Inc. | Clinic/Center | 1540 6th St E, Saint Paul, MN 55106-4806 | 2007-08-21 |
1407049653 | West Side Community Health Services, Inc. | Clinic/Center | 1015 Snelling Ave S, Saint Paul, MN 55116-2447 | 2007-08-21 |
1083765135 | West Side Community Health Services, Inc. | Clinic/Center | 1349 Arcade St, Saint Paul, MN 55106-1801 | 2007-01-16 |
1821149964 | West Side Community Health Services, Inc. | Clinic/Center | 1544 Timberlake Rd, Saint Paul, MN 55117-3946 | 2007-01-16 |
1295886208 | West Side Community Health Services, Inc | Clinic/Center | 183 Old Sixth Street, Saint Paul, MN 55102-1026 | 2007-01-16 |
1104977255 | West Side Community Health Services, Inc. | Clinic/Center | 435 University Ave E, Saint Paul, MN 55101-4437 | 2007-01-16 |
Find all providers in SAINT PAUL |
City | SAINT PAUL |
Zip Code | 55107 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.