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General NPI Number Information
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NPI Number | 1598676876
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Entity Type | Organization
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Legal Business Name | CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION, INC
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Dates
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Enumeration Date | 09/15/2026
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Last Update Date | 09/15/2026
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Provider Practice Location Address
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Address Line | 5677 HIGHLAND DR
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City | JACKSON
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State | MS
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Zip | 39206-3517
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Country | US
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Telephone | 601-362-5321
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Fax |
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Provider Business Mailing Address
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Address Line | 3502 W NORTHSIDE DR JAC JACK
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City | JACKSON
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State | MS
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Zip | 39213-4454
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JO ANN SMITH
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Credential |
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Telephone | 601-362-5321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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