WEST SIDE COMMUNITY HEALTH SERVICES INC. NPI 1104977255

NPI Information

NPI: 1104977255
Provider Name: WEST SIDE COMMUNITY HEALTH SERVICES, INC.

Doing Business As: UNION GOSPEL MISSION

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
435 UNIVERSITY AVE E
SAINT PAUL, MN
ZIP 55101
Phone: (651) 290-6814
Get Directions

WEST SIDE COMMUNITY HEALTH SERVICES, INC. is a federally qualified health center (fqhc) clinic center in Saint Paul, MN. WEST SIDE COMMUNITY HEALTH SERVICES, INC. NPI is 1104977255. The provider is registered as an organization entity type.
The provider Is Doing Business As Union Gospel Mission.

The provider's business location address is:

435 UNIVERSITY AVE E
SAINT PAUL, MN
ZIP 55101-437
Phone: (651) 290-6814
Fax: (651) 290-6818

The provider's authorized official is Mavis Carol Brehm .
The authorized official title is Executive Director and has the following contact phone number (651) 602-7536.

The enumeration date for this NPI number is 1/16/2007 and was last updated on 6/18/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)		MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	076982000	MEDICAID	MINNESOTA
2	241843	MEDICARE OSCAR/CERTIFICATION	MINNESOTA
3	106738	OTHER	MINNESOTA	UCARE
4	C00143	MEDICARE PIN	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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