| NPI | 1962597179 |
|---|---|
| Doing Business As | SOUTH SIDE COMMUNITY HEALTH |
| Doing Business As | SOUTHSIDE COMMUNITY HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | MIKE DALE SHAVER Director Of Reimbursement 423-240-8576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: TN 0000000140) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2022-03-10 |