Humboldt Jr Sr Highschool Clinic

LBN: West Side Community Health Services, Inc.
Humboldt Jr Sr Highschool Clinic is an health care organization with primary practice located at 30 Baker St E , Saint Paul MN 55107-2966. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty. West Side Community Health Services, Inc. can be contacted via phone (651) 312-1996, or through Moore, Reuben via phone (651) 602-7500.

Contact Information

Primary practice address
30 Baker St E Saint Paul MN 55107-2966
Phone: (651) 312-1996
Fax: (651) 312-1997
Website:
Map and Directions
Authorized official contact:
Name: Moore, Reuben
Phone: (651) 602-7500

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X Minnesota

Profile Details

NPI number 1649394727
LBN Legal business name West Side Community Health Services, Inc.
DBA Doing business as Humboldt Jr Sr Highschool Clinic
Authorized official Moore, Reuben
Entity Organization
Organization subpart 1 No
Enumeration date Mar 16th, 2007
Last updated May 15th, 2024 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649394727 NPPES
Minnesota MEDICAID 522927000

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