Basic Information
| Provider Information | |||||||||
| NPI: | 1285977660 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ONEWORLD COMMUNITY HEALTH CENTERS, INC. | ||||||||
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| OtherOrganizationName: | BRYAN HIGH SCHOOL BASED CLINIC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4920 S 30TH ST | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681071590 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4027344110 | ||||||||
| FaxNumber: | 4027343990 | ||||||||
| Practice Location | |||||||||
| Address1: | 4700 GILES RD | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681572641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4029913904 | ||||||||
| FaxNumber: | 4029913916 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2013 | ||||||||
| LastUpdateDate: | 10/15/2013 | ||||||||
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| AuthorizedOfficialLastName: | SKOLKIN | ||||||||
| AuthorizedOfficialFirstName: | ANDREA | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 4025028842 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QF0400X | HC018 | NE | Y | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |
No ID Information.