Provider Demographics
NPI:1912086257
Name:CHOICE FAMILY HEALTH CARE INC.
Entity Type:Organization
Organization Name:CHOICE FAMILY HEALTH CARE INC.
Other - Org Name:CENTRAL HEALTH CENTER INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-384-7625
Mailing Address - Street 1:217 E STOLLEY PARK RD STE E
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-8206
Mailing Address - Country:US
Mailing Address - Phone:308-384-7625
Mailing Address - Fax:308-384-8904
Practice Address - Street 1:217 E STOLLEY PARK RD STE E
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-8206
Practice Address - Country:US
Practice Address - Phone:308-384-7625
Practice Address - Fax:308-384-8904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEHC032261QA0005X
NEHC054261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
099374Medicare ID - Type Unspecified