Organization
CHARLES DREW HEALTH CENTER
Active
Parent organization
CHARLES DREW HEALTH CENTER
Other names
Charles Drew Homeless Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHARLES DREW HEALTH CENTER
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
2915 GRANT STREET, OMAHA, NE 68111-3863
(402) 451-3553
(402) 457-1220
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
NE
363A00000X
Physician Assistant
—
NE
363LC1500X
Community Health Nurse Practitioner
—
NE
Other
Enumeration date
01/05/2016
Last updated
03/19/2021
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