JEFFERSON COMPREHENSIVE CARE SYSTEM, INC (NPI# 1003353111) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003353111 |
| Entity Type | Organization |
| Organization Name | JEFFERSON COMPREHENSIVE CARE SYSTEM, INC |
| Other Organization Name | NORTH LITTLE ROCK COMMUNITY HEALTH CENTER |
| Practice Address |
2525 Willow St Suite # 1 North Little Rock AR 72114-2213 |
| Mailing Address |
Po Box 1285 Pine Bluff AR 71613-1285 |
| Practice Telephone | 8705432380 |
| Mailing Telephone | 8705432311 |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2017-01-26 |
| Authorized Official Name | MS. SANDRA BROWN (CEO) |
| Authorized Official Telephone | 8705432300 |
| Is Organization Subpart | Y |
| Parent Organization Name | JEFFERSON COMPREHENSIVE CARE SYSTEM, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| NORTH LITTLE ROCK COMMUNITY HEALTH CENTER | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396941191 | Jefferson Comprehensive Care System, Inc | Clinic/Center | 505 Sycamore, Rison, AR 71665 | 2007-06-27 |
| 1124224928 | Jefferson Comprehensive Care System, Inc | Clinic/Center | 113 W River Rd, Redfield, AR 72132 | 2007-06-27 |
| 1689870065 | Jefferson Comprehensive Care System, Inc | Clinic/Center | 1225 Dr Martin Luther King Dr, Little Rock, AR 72202-4743 | 2007-06-22 |
| 1154386597 | Jefferson Comprehensive Care System, Inc | Clinic/Center | 1101 Tennessee St, Pine Bluff, AR 71601-5801 | 2006-04-19 |
| 1932305737 | Jefferson Comprehensive Care System, Inc | Clinic/Center | 4206 Frazier Pike, College Station, AR 72053 | 2007-06-27 |
| 1194922849 | Jefferson Comprehensive Care System, Inc | Clinic/Center | 1100 N University Ave, Suite 125, Little Rock, AR 72207-6343 | 2007-06-27 |
| 1730385105 | Jefferson Comprehensive Care System, Inc | Clinic/Center | 309 S Edline, Altheimer, AR 72004-8559 | 2007-06-22 |
| Street Address |
2525 WILLOW ST SUITE # 1 |
| City | NORTH LITTLE ROCK |
| State | AR |
| Zip Code | 72114-2213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316432966 | Mid State Counseling and Recovery Service | Clinic/Center | 1920 Main St Ste 229, North Little Rock, AR 72114 | 2018-06-26 |
| 1053826842 | Kelli Lauron Johnson | Nurse Practitioner | 2800 North Willow Street, North Little Rock, AR 72114 | 2017-12-03 |
| 1689117756 | State of Arkansas | Skilled Nursing Facility | 2401 John Ashley Drive, Building #100, North Little Rock, AR 72114 | 2016-11-22 |
| 1366787459 | J Andrew Mccullough | Counselor | 628 W Broadway St Ste 300, North Little Rock, AR 72114 | 2012-11-30 |
| 1598071490 | Roger Elliott Hicks IIi | Counselor | 2200 Fort Roots Dr # 3d, North Little Rock, AR 72114 | 2010-08-30 |
| 1740594456 | Tuyet Thi Van | Dentist | 520 W. Pershing Blvd., North Little Rock, AR 72114 | 2010-08-05 |
| 1467764183 | Jennifer Leigh Nash | Behavioral Analyst | 628 W Broadway St Ste 100, North Little Rock, AR 72114 | 2010-07-10 |
| 1336398544 | Tina A Davie | Registered Nurse | 2200 Foot Roots Drive, Little Rock, AR 72114 | 2008-09-11 |
| 1316125313 | Centers for Youth & Families | Community/Behavioral Health | 200 W. 20th, North Little Rock, AR 72114 | 2008-02-01 |
| 1881878064 | Marie A Graham | Nurse Practitioner | 636 West Broadway St, No Little Rock, AR 72114 | 2007-12-24 |
| Find all providers in zip 72114 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1669099073 | St Francis House Nwa, Inc | Clinic/Center | 1923 W Pickens Road, Pea Ridge, AR 72751 | 2020-07-01 |
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| 1487280384 | Arcare | Clinic/Center | 2805 Mid Cities Dr Ste 1, Bentonville, AR 72712-4291 | 2020-03-23 |
| 1073144028 | Arcare | Clinic/Center | 145 N Curtis Ave, Pea Ridge, AR 72751-3407 | 2020-01-29 |
| 1396383758 | Mainline Health Systems Inc | Clinic/Center | 1012 E Church St Ste B, Warren, AR 71671-3530 | 2019-12-17 |
| 1275177883 | Boston Mountain Rural Health Center, Inc | Clinic/Center | 1201 North Panther Ave # 3, Yellville, AR 72687 | 2019-11-06 |
| 1649814138 | St Francis House Nwa, Inc | Clinic/Center | 2328 Cardinal Drive, Springdale, AR 72764-4469 | 2019-10-29 |
| 1104469832 | Arcare | Clinic/Center | 501 Millwood Cir Ste E, Maumelle, AR 72113-6304 | 2019-10-25 |
| Find all providers with the same taxonomy | ||||
| City | NORTH LITTLE ROCK |
| Zip Code | 72114 |
Please comment or provide details below to improve the information on JEFFERSON COMPREHENSIVE CARE SYSTEM, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.