Organization · Type 2 NPI

Charles Drew Health Center, Inc

Federally Qualified Health Center (FQHC) · Omaha, NE

NPI number 1003100991 Active

Practice location

1111 North 17th Street
Omaha, NE 68102-4119

Call (402) 346-8401 Map

Fax (402) 453-2061

Mailing address

PO Box 30019
Omaha, NE 68103-1119

Specialties and licenses

Taxonomy	Code	License
Counselor	101Y00000X	None listed
Addiction (Substance Use Disorder) Counselor	101YA0400X	None listed
Mental Health Counselor	101YM0800X	None listed
Mental Health Counselor	101YM0800X	None listed
Psychologist	103T00000X	None listed
Community Health Clinic/Center	261QC1500X	None listed
Community Health Clinic/Center	261QC1500X	None listed
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed
Physician Assistant	363A00000X	None listed
Community Health Nurse Practitioner	363LC1500X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

Another provider at this address

Charles Drew Health CenterFederally Qualified Health Center (FQHC) Omaha, NE NPI 1467818666

Other federally qualified health center (fqhc) providers in Omaha

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NPI record

NPI: 1003100991
Entity type: Organization (Type 2)
Issued: Jun 8, 2011
Last updated: Mar 19, 2021
Status: Active
Subpart: Yes of Charles Drew Health Center, Inc

Other names

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Charles Drew Health Center, Inc at Siena Francis House · doing business as
Charles Drew Health Center, Inc at Siena Francis House · other name
Charles Drew Health Center, Inc at Siena Francis House · other name

Authorized official

Ms. Tarsha Denise Jackson
Chief Financial Officer
(402) 457-1215

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1003100991

Charles Drew Health Center, Inc's National Provider Identifier is 1003100991, issued on Jun 8, 2011. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Omaha, NE. The record was last updated on Mar 19, 2021.