Provider Demographics
NPI:1124021043
Name:CLAY COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:CLAY COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:402-762-3571
Mailing Address - Street 1:202 W FAIRFIELD ST
Mailing Address - Street 2:
Mailing Address - City:CLAY CENTER
Mailing Address - State:NE
Mailing Address - Zip Code:68933-1439
Mailing Address - Country:US
Mailing Address - Phone:402-762-3571
Mailing Address - Fax:402-762-3573
Practice Address - Street 1:202 W FAIRFIELD ST
Practice Address - Street 2:
Practice Address - City:CLAY CENTER
Practice Address - State:NE
Practice Address - Zip Code:68933-1439
Practice Address - Country:US
Practice Address - Phone:402-762-3571
Practice Address - Fax:402-762-3573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE161001251E00000X
NE261QP0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE000676OtherBCBS PROVIDER #
NE000676OtherBCBS PROVIDER #