Organization
SIXTEENTH STREET COMMUNITY HEALTH CENTERS, INC.
Active
Organization
SIXTEENTH STREET COMMUNITY HEALTH CENTERS, INC.
Active
Other names
SSCHC National Ave Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA M STAMPS (CHIEF FINANCIAL OFFICER)
(414) 897-5407
Entity
Organization
Contact information
Practice address
1635 W NATIONAL AVE, MILWAUKEE, WI 53204-1130
(414) 672-1353
(262) 408-5094
Mailing address
PO BOX 778789, CHICAGO, IL 60677-8789
(414) 672-1353
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
225100000X
Physical Therapist
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
367A00000X
Advanced Practice Midwife
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01545
MEDICARE PIN
WI
05
—
1316587439
—
WI
Enumeration date
01/07/2020
Last updated
01/08/2025
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