Organization · NPI-2

16th Street Community Health Center INC.

Clinic/Center, Adolescent and Children Mental Health · Milwaukee, WI

NPI number1750026449
StatusActive
Last updated in NPPESApr 28, 2022

Details

NPI
1750026449
Entity type
Organization (NPI-2)
Legal business name
16th Street Community Health Center INC.
Organization subpart
Yes
Enumeration date
Apr 28, 2022
Certification date
Apr 13, 2022
Last updated
Apr 28, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0855X Clinic/Center, Adolescent and Children Mental Health––Yes
261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC)––

Other names

  • Zablocki Elementary (Other Name)

Practice location

1016 W Oklahoma Ave
Milwaukee, WI 53215-4746

Phone 414-672-1353

Mailing address

Po Box 778789
Chicago, IL 60677-0001

Phone 414-672-1353

Authorized official

Maria Cecilia S Taylor
Cfo
4148975407

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