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General NPI Number Information
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NPI Number | 1639273808
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Entity Type | Organization
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Legal Business Name | JEFFERSON COMMUNITY HEALTH CENTER, INC.
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Dates
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Enumeration Date | 09/11/2006
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Last Update Date | 07/01/2014
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Provider Practice Location Address
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Address Line | 2200 H ST BOX 277
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City | FAIRBURY
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State | NE
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Zip | 68352-1119
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Country | US
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Telephone | 402-729-3351
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Fax | 402-729-2102
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Provider Business Mailing Address
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Address Line | 2200 H ST BOX 277
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City | FAIRBURY
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State | NE
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Zip | 68352-1119
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Country | US
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Telephone | 402-729-3351
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Fax | 402-729-2102
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Authorized Official
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Title or Position | CEO
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Name | CHAD E JURGENS
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Credential |
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Telephone | 402-729-3351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 441001
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License Number State | NE
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