WEST SIDE COMMUNITY HEALTH SERVICES INC. NPI 1649394727

NPI Information

NPI: 1649394727
Provider Name: WEST SIDE COMMUNITY HEALTH SERVICES, INC.

Other Name: HUMBOLDT JR SR HIGHSCHOOL CLINIC

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
30 BAKER ST E
SAINT PAUL, MN
ZIP 55107
Phone: (651) 312-1996
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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 1649394727. The provider is registered as an organization entity type.
The provider Other Name Is Humboldt Jr Sr Highschool Clinic.

The provider's business location address is:

30 BAKER ST E
SAINT PAUL, MN
ZIP 55107-966
Phone: (651) 312-1996
Fax: (651) 312-1997

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 3/16/2007 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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)		MINNESOTA	Yes

Other Identifiers

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

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	241853	MEDICARE OSCAR/CERTIFICATION	MINNESOTA
2	522927000	MEDICAID	MINNESOTA
3	C00143	MEDICARE PIN	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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