Healthcare Provider Details

I. General information

NPI: 1417198367
Provider Name (Legal Business Name): JEFFERSON COMMUNITY HEALTH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2009
Last Update Date: 11/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 H ST
FAIRBURY NE
68352-1119
US

IV. Provider business mailing address

2200 H ST
FAIRBURY NE
68352-1119
US

V. Phone/Fax

Practice location:
  • Phone: 402-729-3351
  • Fax: 402-729-2102
Mailing address:
  • Phone: 402-729-3351
  • Fax: 402-729-2102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberLTCH010
License Number StateNE

VIII. Authorized Official

Name: CHAD E JURGENS
Title or Position: CFO
Credential:
Phone: 402-729-3351