NPI 1003100991 · live from the CMS NPI Registry
Charles Drew Health Center, INC
Clinic/Center, Federally Qualified Health Center (FQHC) in Omaha, NE. National Provider Identifier 1003100991, active.
NPI record
| NPI | 1003100991 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Clinic/Center, Federally Qualified Health Center (FQHC) 261QF0400X |
| Practice location | 1111 North 17th Street, Omaha, NE 68102 |
| Practice phone | 402-346-8401 |
| Mailing address | Po Box 30019, Omaha, NE 68103 |
| Enumerated | June 8, 2011 |
| Last updated | March 19, 2021 |
| Authorized official | Tarsha Jackson, Chief Financial Officer |
| Other names | Charles Drew Health Center, INC At Siena Francis House; Charles Drew Health Center, INC At Siena Francis House |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor | 101Y00000X | — |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | — |
| Counselor, Mental Health | 101YM0800X | — (NE) |
| Counselor, Mental Health | 101YM0800X | — |
| Psychologist | 103T00000X | — |
| Clinic/Center, Community Health | 261QC1500X | — |
| Clinic/Center, Community Health | 261QC1500X | — (NE) |
| Physician Assistant | 363A00000X | — (NE) |
| Nurse Practitioner, Community Health | 363LC1500X | — (NE) |
| Clinic/Center, Federally Qualified Health Center (FQHC) primary | 261QF0400X | — (NE) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.