Mcdonough Homes Clinic

LBN: West Side Community Health Services, Inc.
Mcdonough Homes Clinic is an health care organization with primary practice located at 1544 Timberlake Rd , Saint Paul MN 55117-3946. 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) 558-2191, or through Moore, Reuben via phone (651) 602-7500.

Contact Information

Primary practice address
1544 Timberlake Rd Saint Paul MN 55117-3946
Phone: (651) 558-2191
Fax: (651) 558-2205
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 1821149964
LBN Legal business name West Side Community Health Services, Inc.
DBA Doing business as Mcdonough Homes 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 1821149964 NPPES
Minnesota MEDICAID 072223500
Minnesota Other 173477

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