Southside Family Charter School

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

SOUTHSIDE FAMILY CHARTER SCHOOL

Practice address

4500 Clinton Ave
Minneapolis, MN 55419-5143

Phone

(612) 872-8322

Fax

(612) 872-0612

NPI assigned

Dec 9, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eliza Goodwin

Title

Executive Director

Phone

(612) 872-8322

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323388800000",
    "number": "1902174568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 CLINTON AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554195143",
            "telephone_number": "612-872-8322",
            "fax_number": "612-872-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 CLINTON AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554195143",
            "telephone_number": "612-872-8322",
            "fax_number": "612-872-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE FAMILY CHARTER SCHOOL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-09",
        "last_updated": "2011-12-09",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "ELIZA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "612-872-8322"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southside Community Health Services, Inc.
• Southside Community Health Services, Inc. (Southside East Lake Street Dental Clinic)
• Southside Community Health Services, Inc.
• Southside Community Health Services, Inc.
• Southside Community Health Services, Inc.
• Southside Life Care Center
• Southside Medical Clinic at the Adler Center
• Southside Midwifery Collective Inc
• Southside Transportation LLC
• Bronwyn Southwell, M.D.

• Local Education Agency (LEA) in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Local Education Agency (LEA) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.