Organization
CHARLES DREW HEALTH CENTER, INC
Active
Parent organization
CHARLES DREW HEALTH CENTER, INC
Other names
Charles Drew Health Center, Inc at Siena Francis House, Charles Drew Health Center, Inc at Siena Francis House
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHARLES DREW HEALTH CENTER, INC
Authorized official
MS. TARSHA DENISE JACKSON (CHIEF FINANCIAL OFFICER)
(402) 457-1215
Entity
Organization
Contact information
Practice address
1111 NORTH 17TH STREET, OMAHA, NE 68102-4119
(402) 346-8401
(402) 453-2061
Mailing address
PO BOX 30019, OMAHA, NE 68103-1119
(402) 451-3553
(402) 457-1220
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
NE
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
261QC1500X
Community Health Clinic/Center
—
NE
261QC1500X
Community Health Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
NE
363A00000X
Physician Assistant
—
NE
363LC1500X
Community Health Nurse Practitioner
—
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100260950-00
—
NE
Enumeration date
06/08/2011
Last updated
03/19/2021
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