JEFFERSON COMPREHENSIVE CARE SYSTEM, INC; NPI #1396941191

Contact Information

JEFFERSON COMPREHENSIVE CARE SYSTEM, INC

505 SYCAMORE
RISON, AR 71665

Phone: 870-325-6255
Fax: 870-325-6117
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Federally Qualified Health Center (FQHC)	261QF0400X	B4[14]	Federally Qualified Health Center

Indicates primary specialty

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NPI Profile & details for JEFFERSON COMPREHENSIVE CARE SYSTEM, INC

NPI Number 1396941191

LBN Legal business name JEFFERSON COMPREHENSIVE CARE SYSTEM, INC

Authorized official LARNELL DAVIS - (EXECUTIVE DIRECTOR)

Entity Organization

Organization subpart ¹ Yes

Enumeration date 06/27/2007

Last updated 07/20/2007 - About 19 years ago

Identifiers

Medicaid

122634749

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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