| NPI | 1235133968 |
|---|---|
| Other Name | CCFHC |
| Entity Type | Organization |
| Authorized Contact | LADONNA BEASLEY DAVIS Chief Operating Officer 601-437-3052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2013-09-24 |