Organization
CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION, INC
Active
Other names
Pecan Park Elementary School-Based
Organization subpart
No
Provider details
NPI number
Authorized official
JASMIN CHAPMAN DDS (CHIEF EXECUTIVE OFFICER)
(601) 364-5142
Entity
Organization
Contact information
Practice address
415 CLAIBORNE AVE, JACKSON, MS 39209-5321
(601) 364-5142
Mailing address
3502 W NORTHSIDE DR, JACKSON, MS 39213-4454
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
11/04/2015
Last updated
11/04/2015
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