# SIXTEENTH STREET COMMUNITY HEALTH CENTER, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bay View High School
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407590425
- **Authorized official:** MARIA CECILIA S TAYLOR FACHE, MBA (CFO)
- **Authorized official phone:** (414) 897-5407

## Contact information

- **Practice address:** 2751 S LENOX ST, MILWAUKEE, WI 53207-2299
- **Practice address phone:** (414) 672-1353
- **Mailing address:** PO BOX 778789, CHICAGO, IL 60677-0001
- **Mailing address phone:** (414) 672-1353
- **Mailing address fax:** (414) 672-0191

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QF0400X | Federally Qualified Health Center (FQHC) | — | — | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 04/26/2022
- **Last updated:** 04/26/2022