| Vicksburg Community Center | |
|
2845 Clay St Vicksburg MS 39183-3141 | |
| (601) 218-5927 | |
| Not Available |
| Full Name | Vicksburg Community Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2845 Clay St, Vicksburg, Mississippi |
| Authorized Official Name and Position | Ashley Danielle Johnson (DIRECTOR) |
| Authorized Official Contact | 6012185927 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vicksburg Community Center Po Box 821634 Vicksburg MS 39182-1634 Ph: (601) 218-5927 | Vicksburg Community Center 2845 Clay St Vicksburg MS 39183-3141 Ph: (601) 218-5927 |
| NPI Number | 1407284102 |
|---|---|
| Provider Enumeration Date | 10/16/2013 |
| Last Update Date | 10/16/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407284102 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Mississippi) | Primary |
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