Organization
CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION, INC
Active
Other names
The Village Apartment Complex
Organization subpart
No
Provider details
NPI number
Authorized official
JASMIN CHAPMAN DDS (CHIEF EXECUTIVE OFFICER)
(601) 364-5142
Entity
Organization
Contact information
Practice address
386 RAYMOND RD, JACKSON, MS 39204-3700
(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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