Provider Demographics
NPI:1225194780
Name:GOOD NEIGHBOR COMMUNITY HEALTH CENTER
Entity Type:Organization
Organization Name:GOOD NEIGHBOR COMMUNITY HEALTH CENTER
Other - Org Name:GNCHC MENTAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERMIN CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RODGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-562-8952
Mailing Address - Street 1:4321 41ST AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-2131
Mailing Address - Country:US
Mailing Address - Phone:402-562-8952
Mailing Address - Fax:402-564-0611
Practice Address - Street 1:4321 41ST AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-2131
Practice Address - Country:US
Practice Address - Phone:402-562-8952
Practice Address - Fax:402-564-0611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2017-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEHC036251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1225194780OtherMIDLANDS CHOICE
NEB67865OtherBCBS
NE10025079900Medicaid
NE281808OtherMEDICARE FQHC
NE10025079900Medicaid