Organization
SOUTHSIDE COMMUNITY HEALTH SERVICES, INC.
Active
Organization
SOUTHSIDE COMMUNITY HEALTH SERVICES, INC.
Active
Other names
Southside Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ANN CAZABAN JR. (EXECUTIVE DIRECTOR)
(612) 821-2025
Entity
Organization
Contact information
Practice address
1000 E LAKE ST, MINNEAPOLIS, MN 55407-1617
(612) 827-7181
(612) 767-4545
Mailing address
4243 4TH AVE S, MINNEAPOLIS, MN 55409-2113
(612) 821-2799
(612) 821-2818
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
343814700
—
MN
Enumeration date
03/14/2006
Last updated
08/07/2026
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