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General NPI Number Information
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NPI Number | 1669274452
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Entity Type | Organization
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Legal Business Name | WESTSIDE FAMILY HEALTHCARE, INC
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Dates
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Enumeration Date | 03/25/2025
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 3000 N CLAYMONT ST
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City | WILMINGTON
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State | DE
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Zip | 19802-2807
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Country | US
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Telephone | 302-224-6800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 151
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City | NEW CASTLE
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State | DE
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Zip | 19720-0151
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Country | US
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Telephone | 302-656-8292
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | CHRISTOPHER FRASER
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Credential | FACHE
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Telephone | 302-584-6290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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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 | 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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