| Teen And Young Adult Health Center | |
|
4310 S 24th St Omaha NE 68107-1805 | |
| (402) 502-8880 | |
| (402) 502-8884 |
| Full Name | Teen And Young Adult Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 4310 S 24th St, Omaha, Nebraska |
| Authorized Official Name and Position | Andrea M Skolkin (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4025028842 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Teen And Young Adult Health Center 4920 S 30th St Suite 103 Omaha NE 68107-1590 Ph: (402) 734-4110 | Teen And Young Adult Health Center 4310 S 24th St Omaha NE 68107-1805 Ph: (402) 502-8880 |
| NPI Number | 1144690074 |
|---|---|
| Provider Enumeration Date | 10/05/2015 |
| Last Update Date | 10/06/2015 |
| Medicare PECOS PAC ID | 3173435153 |
|---|---|
| Medicare Enrollment ID | O20160114001221 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144690074 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | HC018 (Nebraska) | Primary |
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