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Organization
CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION, INC
Active
Organization
CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION, INC
Active
Other names
Gary Road Intermediate School, Gary Road Elementary School
Organization subpart
No
Provider details
NPI number
Authorized official
JASMIN CHAPMAN DDS (CHIEF EXECUTIVE OFFICER)
(601) 364-5142
Entity
Organization
Contact information
Practice address
7255 GARY RD, BYRAM, MS 39272-8947
(601) 894-8590
Mailing address
3502 W NORTHSIDE DR, JACKSON, MS 39213-4454
(601) 362-5321
(601) 364-5159
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MS
Enumeration date
05/30/2017
Last updated
06/16/2018
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