Basic Information
| Provider Information | |||||||||
| NPI: | 1902175755 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GOOD NEIGHBOR COMMUNITY HEALTH CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2282 E 32ND AVE | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | NE | ||||||||
| PostalCode: | 686017233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4025627500 | ||||||||
| FaxNumber: | 4025640611 | ||||||||
| Practice Location | |||||||||
| Address1: | 4500 63RD ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | NE | ||||||||
| PostalCode: | 686018031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4025628952 | ||||||||
| FaxNumber: | 4025640611 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/23/2011 | ||||||||
| LastUpdateDate: | 12/27/2011 | ||||||||
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| AuthorizedOfficialLastName: | RAYMAN | ||||||||
| AuthorizedOfficialFirstName: | REBECCA | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4025628950 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QF0400X | HC036 | NE | Y | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |
No ID Information.