Johnson High School Clinic

LBN: West Side Community Health Services, Inc.
Johnson High School Clinic is an health care organization with primary practice located at 1349 Arcade St , Saint Paul MN 55106-1801. 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) 778-2889, or through Moore, Reuben via phone (651) 602-7500.

Contact Information

Primary practice address
1349 Arcade St Saint Paul MN 55106-1801
Phone: (651) 778-2889
Fax: (651) 778-2890
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 1083765135
LBN Legal business name West Side Community Health Services, Inc.
DBA Doing business as Johnson High School Clinic
Authorized official Moore, Reuben
Entity Organization
Organization subpart 1 No
Enumeration date Jan 16th, 2007
Last updated May 15th, 2024 - about 7 months 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 1083765135 NPPES
Minnesota MEDICAID 523083700
Minnesota Other 103124

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