| Central Mississippi Civic Improvement Association, Inc | |
|
500 W County Line Rd Tougaloo MS 39174-9700 | |
| (601) 978-3095 | |
| (601) 978-3938 |
| Full Name | Central Mississippi Civic Improvement Association, Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 500 W County Line Rd, Tougaloo, Mississippi |
| Authorized Official Name and Position | Jasmin Chapman (CEO) |
| Authorized Official Contact | 6013625321 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Mississippi Civic Improvement Association, Inc 3502 W Northside Dr Jackson MS 39213-4454 Ph: (601) 362-5321 | Central Mississippi Civic Improvement Association, Inc 500 W County Line Rd Tougaloo MS 39174-9700 Ph: (601) 978-3095 |
| NPI Number | 1235167891 |
|---|---|
| Provider Enumeration Date | 06/30/2006 |
| Last Update Date | 02/03/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235167891 | NPI | - | NPPES |
| 09016118 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Premier Rehab Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 West Countyline Rd, Tougaloo, MS 39174 Phone: 601-636-6019 Fax: 601-661-8457 | |
Central Mississippi Health Services, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 500 W County Line Rd, Tougaloo, MS 39174 Phone: 601-948-5574 Fax: 601-353-7070 |