MEDICARE: CATHOLIC CHARITIES OF THE ARCHDIOCESE OF OMAHA, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639592348
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATHOLIC CHARITIES OF THE ARCHDIOCESE OF OMAHA, INC

Provider Business Mailing Address
First Line	:	3300 N 60TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68104-3402
Country	:	US
Telephone Number	:	402-554-0520
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 N 60TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68104-3402
Country	:	US
Telephone Number	:	402-554-0520
Fax Number	:

Authorized Official
Title or Position	:	SENIOR FINANCE DIRECTOR
Name	:	THERESA ROSS
Credential	:
Telephone Number	:	402-829-9292

Provider Enumeration Date	:	01/31/2014
Last Update Date	:	01/31/2014

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