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Organization

CHARLES DREW HEALTH CENTER INC

Active
Parent organization
CHARLES DREW HEALTH CENTER INC
Other names
Charles Drew Health Center at Campus For Hope
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
1490 NORTH 16TH STREET, OMAHA, NE 68102-4118
(402) 346-8401
(402) 453-2061
Mailing address
PO BOX 30019, 2915 GRANT STREET, OMAHA, NE 68103-1119
(402) 451-3553
(402) 457-1220

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
NE
261QC1500X
Community Health Clinic/Center
NE
261QC1500X
Community Health Clinic/Center
NH
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
100260951-00
NE
Enumeration date
06/08/2011
Last updated
03/19/2021
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