| NPI | 1053571711 |
|---|---|
| Doing Business As | JCCSI CROSS OVER |
| Entity Type | Organization |
| Authorized Contact | LARNELL W DAVIS Executive Director 870-543-2380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2008-06-16 |