| Organization Name: | CENTRAL MS SCHOOL BASED HEALTH LLC. |
| NPI Number: | 1851623664 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CYNTHIA JOHNSON DEAN (PROVIDER/OWNER) |
| Mailing Address: | 2268 College Street Ethel |
| State: | MS US |
| Postal Code: | 39067 |
| Phone Number: | 6626740198 |
| Fax Number: | 6626740098 |
| NPI Enumeration Date: | 02/03/2010 |
| NPI Last Update Date: | 02/03/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R853619 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |