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General NPI Number Information
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NPI Number | 1083679385
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Entity Type | Organization
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Legal Business Name | SIXTEENTH STREET COMMUNITY HEALTH CENTER INC.
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 309 E NORTH ST
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City | WAUKESHA
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State | WI
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Zip | 53188-3718
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Country | US
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Telephone | 414-672-1353
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Fax |
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Provider Business Mailing Address
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Address Line | 2906 S 20TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53215-3732
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Country | US
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Telephone | 414-672-1353
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Fax | 414-672-4265
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | TANYA M STAMPS
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Credential |
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Telephone | 414-897-5407
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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