Provider Demographics
NPI:1710865803
Name:AARON E. HENRY COMMUNITY HEALTH SERVICES CENTER, INC
Entity type:Organization
Organization Name:AARON E. HENRY COMMUNITY HEALTH SERVICES CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAQUITTA
Authorized Official - Middle Name:R
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:662-624-4292
Mailing Address - Street 1:600 OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:CLARKSDALE
Mailing Address - State:MS
Mailing Address - Zip Code:38614-6020
Mailing Address - Country:US
Mailing Address - Phone:662-624-4292
Mailing Address - Fax:662-351-3303
Practice Address - Street 1:600 OHIO AVE
Practice Address - Street 2:
Practice Address - City:CLARKSDALE
Practice Address - State:MS
Practice Address - Zip Code:38614-6020
Practice Address - Country:US
Practice Address - Phone:662-624-4292
Practice Address - Fax:662-351-3303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)