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CH04033O Jessie Trice Community Health Center, Inc. (Terminated)
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Main Details
Name
Jessie Trice Community Health Center, Inc.
Subdivision Name
MIAMI EDISON SENIOR HIGH SCHOOL
Type
HRSA-Funded Health Center
Site ID
BPS-H80-004658
340B ID
CH04033O
Grant Number
H80CS00732
Additional Details
Current Program Status
Terminated
Registration Date
9/16/2008
Participating Start Date
9/17/2008
Participating Approval Date
9/17/2008
Last Recertification Date
3/7/2016
Termination Date
Termination Reason
4/1/2016
Site closure
Contacts
Authorizing Official
Jessie Trice Community Health Center, Inc
Annie Neasman, President & CEO
(305) 805-1700 Ext: 1000
Primary Contact
Claude Jones, CHIEF MEDICAL OFFICER
(305) 805-1700 Ext: 23162
Addresses
Street Address
6161 NW 5TH CT RM A-
MIAMI, FL 33127-1259
Billing Address
JESSIE TRICE COMMUNITY HEALTH CENTER INC.
5601 NW 27TH AVENUE, SUITE 1
MIAMI, FL 33142
Comments
Medicaid Billing
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