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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