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Organization

COUNCIL BLUFFS COMMUNITY HEALTH CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. GERRI L BRUNOW CPC (AR MANAGER)
(712) 256-6577
Entity
Organization

Contact information

Practice address
2700 COLLEGE RD, A104, COUNCIL BLUFFS, IA 51503-1057
(712) 325-3351
(712) 325-3739
Mailing address
300 WEST BROADWAY, SUITE 6, COUNCIL BLUFFS, IA 51503-9040
(712) 256-6577
(712) 325-1932

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0188946
IA
01
16D0949735
CLIA
Enumeration date
08/06/2007
Last updated
04/20/2008
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