Healthcare Provider Details

I. General information

NPI: 1124021043
Provider Name (Legal Business Name): CLAY COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 06/19/2023
Certification Date: 04/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 W FAIRFIELD ST
CLAY CENTER NE
68933-1439
US

IV. Provider business mailing address

202 W FAIRFIELD ST
CLAY CENTER NE
68933-1439
US

V. Phone/Fax

Practice location:
  • Phone: 402-762-3571
  • Fax: 402-762-3573
Mailing address:
  • Phone: 402-762-3571
  • Fax: 402-762-3573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number161001
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number StateNE

VIII. Authorized Official

Name: DONNA JENSEN
Title or Position: DIRECTOR
Credential: R.N.
Phone: 402-762-3571