Provider Demographics
NPI:1740491786
Name:GOOD NEIGHBOR COMMUNITY HEALTH CENTER
Entity type:Organization
Organization Name:GOOD NEIGHBOR COMMUNITY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD-WOLFGRAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-562-7500
Mailing Address - Street 1:4321 41ST AVENUE
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
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:2007-05-24
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025076100Medicaid
NE1740491786OtherMIDLANDS CHOICE
NE35016OtherBCBS
NE10024980200Medicaid
NE10024980200Medicaid
NE281808Medicare ID - Type UnspecifiedMEDICARE FQHC