CHARLES DREW HEALTH CENTER INC NPI 1023365582

NPI Information

NPI: 1023365582
Provider Name: CHARLES DREW HEALTH CENTER, INC

Other Name: CHARLES DREW HEALTH CENTER, INC AT EVANS TOWER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
3600 NORTH 24TH STREET
OMAHA, NE
ZIP 68110
Phone: (402) 457-1242
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CHARLES DREW HEALTH CENTER, INC is a federally qualified health center (fqhc) clinic center in Omaha, NE. CHARLES DREW HEALTH CENTER, INC NPI is 1023365582. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Charles Drew Health Center, Inc At Evans Tower.

The provider's business location address is:

3600 NORTH 24TH STREET
OMAHA, NE
ZIP 68110-872
Phone: (402) 457-1242

The provider's authorized official is Tarsha Denise Jackson .
The authorized official title is Chief Financial Officer and has the following contact phone number (402) 457-1215.

The enumeration date for this NPI number is 8/14/2012 and was last updated on 3/19/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	101Y00000X	Counselor			No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)		No
3	101YM0800X	Counselor	Mental Health		No
4	103T00000X	Psychologist			No
5	261QC1500X	Clinic/Center	Community Health	NEBRASKA	No
6	363LC1500X	Nurse Practitioner	Community Health		No
7	363LC1500X	Nurse Practitioner	Community Health	NEBRASKA	No
8	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	NEBRASKA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100262750-00	OTHER	NEBRASKA	NON-FQHC
2	100262749-00	MEDICAID	NEBRASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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