Organization
SIXTEENTH STREET COMMUNITY HEALTH CENTER, INC
Active
Parent organization
16TH STREET COMMUNITY HEALTH CENTER, INC
Other names
La Casa De Esperanza
Organization subpart
Yes
Provider details
NPI number
Legal business name
16TH STREET COMMUNITY HEALTH CENTER, INC
Authorized official
MARIA CECILIA S TAYLOR (CFO)
(414) 897-5407
Entity
Organization
Contact information
Practice address
410 ARCADIAN AVE, WAUKESHA, WI 53186-5086
(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
04/11/2022
Last updated
04/11/2022
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