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AARON E. HENRY COMMUNITY HEALTH SERVICES CENTER, INC.

Company Details

Name: AARON E. HENRY COMMUNITY HEALTH SERVICES CENTER, INC.
Jurisdiction: MISSISSIPPI
Business Type: Non Profit Corporation
Status: Good Standing
Effective Date: 27 Apr 1979 (46 years ago)
Business ID: 102898
State of Incorporation: MISSISSIPPI
Principal Office Address: P O BOX 853CLARKSDALE, MS

Agent

Name Role Address
FREELAND MARTZ, PLLC Agent 302 Enterprise Drive, Suite A, Oxford, MS 38655

Incorporator

Name Role Address
NOELLE HENRY Incorporator 636 PAGE ST, CLARKSDALE, MS
VIVIAN S JOHNSON Incorporator 1010 6TH ST, CLARKSDALE, MS
WILLIE B GREGORY Incorporator 951 RICHARDSON COVE, APT 2, CLARKSDALE, MS

Assistant Secretary

Name Role Address
Errol Castens Assistant Secretary 302 Enterprise Drive, Suite A, Oxford, MS 38655

Unique Entity ID

A UEI is a government-provided number, like a tax ID number, that’s used to identify businesses eligible for federal grants, awards and contracts.

Note: In April 2022, the federal government replaced its old identifier of choice, the Data Universal Numbering System (DUNS) number, with a government-issued UEI. Now all the federal government’s Integrated Award Environment systems use UEI numbers instead of DUNS numbers. So any entity doing business with the federal government must register for a UEI.

Unique Entity ID:
EKKFR7V1XZ58
CAGE Code:
4CTP1
UEI Expiration Date:
2026-04-02

Business Information

Activation Date:
2025-04-02
Initial Registration Date:
2006-03-31

National Provider Identifier

NPI Number:
1134868672
Certification Date:
2022-06-02

Authorized Person:

Name:
CANDACE L FONDREN
Role:
REVENUE CYCLE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
208000000X - Pediatrics Physician
Is Primary:
Yes

Contacts:

Fax:
6626244354

Form 5500 Series

Employer Identification Number (EIN):
640624495
Plan Year:
2019
Number Of Participants:
0
Sponsors Telephone Number:

Filings

Type Status Filed Date Description
Amendment Form Filed 2023-07-25 Amendment For AARON E. HENRY COMMUNITY HEALTH SERVICES CENTER, INC.
Amendment Form Filed 2001-03-15 Amendment
See File Filed 1982-12-10 See File
Amendment Form Filed 1982-04-27 Amendment
Name Reservation Form Filed 1979-04-27 Name Reservation

USAspending Awards / Financial Assistance

Date:
2023-09-26
Awarding Agency Name:
Department of Agriculture
Transaction Description:
PERSISTENT POVERTY DHCS GRANT - CONACT SEC 379G DELTA HEALTH CARE SERVICES GRANT
Obligated Amount:
999438.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2023-08-28
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
FY 2023 BRIDGE ACCESS PROGRAM
Obligated Amount:
30091.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2023-05-18
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
FY 2023 EXPANDING COVID-19 VACCINATION
Obligated Amount:
150921.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2021-09-20
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
HEALTH CENTER INFRASTRUCTURE SUPPORT
Obligated Amount:
653780.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2021-03-27
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
AMERICAN RESCUE PLAN ACT FUNDING FOR HEALTH CENTERS
Obligated Amount:
3052500.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00

Paycheck Protection Program

Date Approved:
2021-03-12
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
1472410
Current Approval Amount:
1472410
Race:
American Indian or Alaska Native
Ethnicity:
Not Hispanic or Latino
Gender:
Female Owned
Veteran:
Non-Veteran
Forgiveness Amount:
1485359.14
Date Approved:
2020-04-13
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
1472400
Current Approval Amount:
1472400
Race:
American Indian or Alaska Native
Ethnicity:
Not Hispanic or Latino
Gender:
Female Owned
Veteran:
Non-Veteran
Forgiveness Amount:
1482646.29

Date of last update: 30 May 2025

Sources: Company Profile on Mississippi Secretary of State Website