CHARLES DREW HEALTH CENTER INC NPI 1285090472

NPI Information

NPI: 1285090472
Provider Name: CHARLES DREW HEALTH CENTER INC

Doing Business As: CHARLES DREW HEALTH CENTER INC AT CAMPUS FOR HOPE

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

Specialization: Federally Qualified Health Center (FQHC)

Address:
1490 NORTH 16TH STREET
OMAHA, NE
ZIP 68102
Phone: (402) 346-8401
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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 1285090472. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Charles Drew Health Center Inc At Campus For Hope.

The provider's business location address is:

1490 NORTH 16TH STREET
OMAHA, NE
ZIP 68102-118
Phone: (402) 346-8401
Fax: (402) 453-2061

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 1/5/2016 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	101YM0800X	Counselor	Mental Health	NEBRASKA	No
2	103T00000X	Psychologist		NEBRASKA	No
3	363A00000X	Physician Assistant		NEBRASKA	No
4	363LC1500X	Nurse Practitioner	Community Health	NEBRASKA	No
5	101Y00000X	Counselor		NEBRASKA	No
6	101YA0400X	Counselor	Addiction (Substance Use Disorder)	NEBRASKA	No
7	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	10026095100	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: 11/14/2023

NPI Synchronization or Removal

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