Organization
16TH STREET COMMUNITY HEALTH CENTER INC.
Active
Other names
SSCHC Chavez Clinic, Sixteenth Street Community Health Center Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA CECILIA S TAYLOR (CFO)
(414) 803-6395
Entity
Organization
Contact information
Practice address
1032 S CESAR E CHAVEZ DR, MILWAUKEE, WI 53204-2203
(414) 672-1353
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
—
WI
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
—
WI
363L00000X
Nurse Practitioner
—
—
367A00000X
Advanced Practice Midwife
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417912999
—
WI
Enumeration date
04/19/2006
Last updated
10/17/2024
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