WEST SIDE COMMUNITY HEALTH SERVICES INC. NPI 1083765135

NPI Information

WEST SIDE COMMUNITY HEALTH SERVICES, INC. is a federally qualified health center (fqhc) clinic center in Saint Paul, MN. WEST SIDE COMMUNITY HEALTH SERVICES, INC. NPI is 1083765135. The provider is registered as an organization entity type.
The provider Is Doing Business As Johnson High School Clinic.

The provider's business location address is:

1349 ARCADE ST
SAINT PAUL, MN
ZIP 55106-801
Phone: (651) 778-2889
Fax: (651) 778-2890

The provider's authorized official is Mavis Carol Brehm .
The authorized official title is Executive Director and has the following contact phone number (651) 602-7536.

The enumeration date for this NPI number is 1/16/2007 and was last updated on 6/18/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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