Organization
WEST SIDE COMMUNITY HEALTH SERVICES, INC.
Active
Other names
East Side Family Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. REUBEN MOORE (EXECUTIVE DIRECTOR)
(651) 602-7500
Entity
Organization
Contact information
Practice address
895 7TH ST E, SAINT PAUL, MN 55106-3871
(651) 602-7500
(651) 602-7513
Mailing address
153 CESAR CHAVEZ ST, SAINT PAUL, MN 55107-2226
(651) 602-7500
(651) 602-7513
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104017
UCARE FACILITY ID
MN
05
—
377150400
—
MN
Enumeration date
01/08/2007
Last updated
05/15/2024
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