Vicksburg Community Center

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

VICKSBURG COMMUNITY CENTER

Practice address

2845 Clay St
Vicksburg, MS 39183-3141

Phone

(601) 218-5927

NPI assigned

Oct 16, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Ashley Danielle Johnson

Title

Director

Phone

(601) 218-5927

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381881600000",
    "number": "1407284102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 821634",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391821634",
            "telephone_number": "601-218-5927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 CLAY ST",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391833141",
            "telephone_number": "601-218-5927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICKSBURG COMMUNITY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-16",
        "last_updated": "2013-10-16",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "DANIELLE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "601-218-5927",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Vicksburg Convalescent, LLC
• Vicksburg Emergency Physicians LLP
• Vicksburg Family Dental
• Vicksburg Family Dental 61N
• Vicksburg HB Medical Services LLC

• Community/Behavioral Health Agency in Vicksburg, MS
• Providers in Vicksburg, MS by specialty
• Community/Behavioral Health Agency in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.