Organization · NPI-2

16th Street Community Health Center INC.

Clinic/Center, Federally Qualified Health Center (FQHC) · Waukesha, WI

NPI number1144593815
StatusActive
Last updated in NPPESJan 8, 2025

Details

NPI
1144593815
Entity type
Organization (NPI-2)
Legal business name
16th Street Community Health Center INC.
Organization subpart
No
Enumeration date
Feb 10, 2012
Certification date
Jan 8, 2025
Last updated
Jan 8, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC)1507-800WIYes
101Y00000X Counselor––
103T00000X Psychologist––
104100000X Social Worker––
207Q00000X Family Medicine––
207R00000X Internal Medicine––
207V00000X Obstetrics & Gynecology––
208000000X Pediatrics––
225100000X Physical Therapist––
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––
261QM0855X Clinic/Center, Adolescent and Children Mental Health––
261QM1300X Clinic/Center, Multi-Specialty––
363A00000X Physician Assistant––
363L00000X Nurse Practitioner––
367A00000X Advanced Practice Midwife––

Other names

  • Sixteenth Street Community Health Centers (Doing Business As)
  • Sixteenth Street Community Health Center INC. (Former Legal Business Name)
  • 16th Street Community Health Center INC. (Doing Business As)
  • Sixteenth Street Community Health Centers INC (Other Name)

Practice location

309 E North St
Waukesha, WI 53188-3718

Phone 414-672-1353 · Fax 262-408-5094

Mailing address

Po Box 778789
Chicago, IL 60677-8789

Phone 414-672-1353 · Fax 262-408-5094

Authorized official

Tanya M Stamps
Chief Financial Officer
4148975407

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