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Organization
SIXTEENTH STREET COMMUNITY HEALTH CENTER, INC
Active
Organization
SIXTEENTH STREET COMMUNITY HEALTH CENTER, INC
Active
Other names
Bay View High School
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA CECILIA S TAYLOR FACHE, MBA (CFO)
(414) 897-5407
Entity
Organization
Contact information
Practice address
2751 S LENOX ST, MILWAUKEE, WI 53207-2299
(414) 672-1353
Mailing address
PO BOX 778789, CHICAGO, IL 60677-0001
(414) 672-1353
(414) 672-0191
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/26/2022
Last updated
04/26/2022
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