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General NPI Number Information
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NPI Number | 1982895942
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Entity Type | Organization
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Legal Business Name | COUNCIL BLUFFS COMMUNITY HEALTH CENTER
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Dates
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Enumeration Date | 08/06/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 2700 COLLEGE RD A104
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-1057
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Country | US
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Telephone | 712-325-3351
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Fax | 712-325-3739
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Provider Business Mailing Address
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Address Line | 300 WEST BROADWAY SUITE 6
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-9040
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Country | US
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Telephone | 712-256-6577
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Fax | 712-325-1932
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Authorized Official
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Title or Position | AR MANAGER
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Name | MRS. GERRI L BRUNOW
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Credential | CPC
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Telephone | 712-256-6577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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