Organization
JEFFERSON COMPREHENSIVE CARE SYSTEM, INC
Active
Parent organization
JEFFERSON COMPREHENSIVE CARE SYSTEM, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
JEFFERSON COMPREHENSIVE CARE SYSTEM, INC
Authorized official
MR. LARNELL W DAVIS (EXECUTIVE DIRECTOR)
(870) 543-2380
Entity
Organization
Contact information
Practice address
1101 TENNESSEE ST, PINE BLUFF, AR 71601-5801
(870) 543-2380
(870) 535-4716
Mailing address
PO BOX 1285, PINE BLUFF, AR 71613-1285
(870) 543-2380
(870) 535-4716
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
04/19/2006
Last updated
07/20/2007
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