Provider Demographics
NPI:1417013350
Name:GOOD NEIGHBOR COMMUNITY HEALTH CENTER
Entity Type:Organization
Organization Name:GOOD NEIGHBOR COMMUNITY HEALTH CENTER
Other - Org Name:GOOD NEIGHBOR COMMUNITY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:J
Authorized Official - Last Name:RAYMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-563-9224
Mailing Address - Street 1:2282 E 32ND AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-7233
Mailing Address - Country:US
Mailing Address - Phone:402-563-9224
Mailing Address - Fax:402-564-0611
Practice Address - Street 1:2282 E 32ND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-7233
Practice Address - Country:US
Practice Address - Phone:402-563-9224
Practice Address - Fax:402-564-0611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEHCO36251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE----5076100Medicaid
NE----4980200Medicaid
NE----4980200Medicaid
NE----5076100Medicaid