Organization
CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION
Active
Other names
Jackson Hinds Comprehensive Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASMIN CHAMPMAN DDS (CEO)
(601) 362-5321
Entity
Organization
Contact information
Practice address
3312 OAK ST, VICKSBURG, MS 39180-5042
(601) 629-9500
(601) 638-9044
Mailing address
3502 W NORTHSIDE DR, JACKSON, MS 39213-4454
(601) 362-5321
(601) 364-2600
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09014146
—
MS
Enumeration date
07/07/2006
Last updated
09/20/2007
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