CHARLES DREW HEALTH CENTER INC NPI 1285941997

NPI Information

NPI: 1285941997
Provider Name: CHARLES DREW HEALTH CENTER, INC

Doing Business As: CHARLES DREW HEALTH CENTER, INC AT KELLOM ELEMENTARY SCHOOL

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

Specialization: Federally Qualified Health Center (FQHC)

Address:
1311 NORTH 24TH STREET
OMAHA, NE
ZIP 68102
Phone: (402) 505-5451
Get Directions

CHARLES DREW HEALTH CENTER, INC is a federally qualified health center (fqhc) clinic center in Omaha, NE. CHARLES DREW HEALTH CENTER, INC NPI is 1285941997. 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 Kellom Elementary School.

The provider's business location address is:

1311 NORTH 24TH STREET
OMAHA, NE
ZIP 68102-010
Phone: (402) 505-5451
Fax: (402) 504-1240

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 9/2/2010 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	103T00000X	Psychologist			No
2	163WC1500X	Registered Nurse	Community Health	NEBRASKA	No
3	261QC1500X	Clinic/Center	Community Health		No
4	261QC1500X	Clinic/Center	Community Health	NEBRASKA	No
5	101Y00000X	Counselor			No
6	101YA0400X	Counselor	Addiction (Substance Use Disorder)		No
7	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	NEBRASKA	Yes
8	101YM0800X	Counselor	Mental Health		No

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	100262313-00	OTHER	NEBRASKA	NON-FQHC
2	100262311-00	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: 11/14/2023

NPI Synchronization or Removal

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