NPI 1639486343 · live from the CMS NPI Registry
Charles Drew Health Center, INC
Clinic/Center, Federally Qualified Health Center (FQHC) in Omaha, NE. National Provider Identifier 1639486343, active.
NPI record
| NPI | 1639486343 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Clinic/Center, Federally Qualified Health Center (FQHC) 261QF0400X |
| Practice location | 3720 Florence Blvd, Omaha, NE 68110 |
| Practice phone | 402-502-5644 |
| Mailing address | Po Box 30019, 2915 Grant Street, Omaha, NE 68111 |
| Enumerated | September 2, 2010 |
| Last updated | May 10, 2021 |
| Authorized official | Tarsha Jackson, Chief Financial Officer |
| Other names | Charles Drew Health Center, INC At King Science And Techonology Magnet School; Charles Drew Health Center, INC At King Science Center Sbhc |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist | 103T00000X | — |
| Counselor | 101Y00000X | — |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | — |
| Registered Nurse, Community Health | 163WC1500X | — (NE) |
| Clinic/Center, Community Health | 261QC1500X | — |
| Counselor, Mental Health | 101YM0800X | — |
| Clinic/Center, Community Health | 261QC1500X | — (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.