Provider Demographics
NPI:1376618215
Name:HELP FOUNDATION OF OMAHA, INC
Entity Type:Organization
Organization Name:HELP FOUNDATION OF OMAHA, INC
Other - Org Name:PARK PLAZA URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:RT(R)(M)(CT)
Authorized Official - Phone:402-715-5200
Mailing Address - Street 1:105 NORTH 31ST AVENUE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131
Mailing Address - Country:US
Mailing Address - Phone:402-346-1111
Mailing Address - Fax:402-408-0004
Practice Address - Street 1:105 NORTH 31ST AVENUE
Practice Address - Street 2:SUITE 102
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131
Practice Address - Country:US
Practice Address - Phone:402-346-1111
Practice Address - Fax:402-408-0004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13501174400000X, 207X00000X
NE1574207Q00000X
NE23560207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE363428793-00Medicaid
099234Medicare PIN
NE5492420001Medicare NSC