Organization
CHARLES DREW HEALTH CENTER INC
Active
Parent organization
CHARLES DREW HEALTH CENTER INC
Other names
Charles Drew Health Center Inc at St. Richards
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHARLES DREW HEALTH CENTER INC
Authorized official
MISS TARSHA DENISE JACKSON (CFO)
(402) 457-1215
Entity
Organization
Contact information
Practice address
4320 FORT ST, OMAHA, NE 68111-1849
(402) 451-3553
(402) 453-1970
Mailing address
PO BOX 30019, OMAHA, NE 68103-1119
(402) 451-3553
(402) 453-1970
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NE
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NE
103T00000X
Psychologist
—
NE
261QC1500X
Community Health Clinic/Center
—
NE
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
NE
363A00000X
Physician Assistant
—
NE
363L00000X
Nurse Practitioner
—
NE
363LC1500X
Community Health Nurse Practitioner
—
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026276401
—
NE
Enumeration date
07/09/2015
Last updated
03/30/2021
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