Jalisa Jackson
Community Based Residential Treatment Facility, Mental Illness in Charlotte, NC. Individual provider (NPI-1).
NPI number1366041667
StatusActive
Last updated in NPPESOct 19, 2020
Details
- NPI
- 1366041667
- Entity type
- Individual (NPI-1)
- Name
- Jalisa Jackson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 19, 2020
- Certification date
- Oct 19, 2020
- Last updated
- Oct 19, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | MHL-036-348 | NC | Yes |
Practice location
11413 Mangla DrCharlotte, NC 28214-8885
Phone 704-819-4909
Mailing address
11413 Mangla DrCharlotte, NC 28214-8885
Phone 704-819-4909
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Mental Illness Community Based Residential Treatment Facility providers in Charlotte, NC
- 2nd II None FoundationNPI 1407903941
- 2nd II None FoundationNPI 1578610929
- 2nd II None- Barnhardt Group HomeNPI 1902097603
- 2nd II None- Hanna Group HomeNPI 1366633075
- A Caring Home, INC.NPI 1780738393
- A Peaceful BridgeNPI 1578461208
- A Place 4 Me, LLCNPI 1306455126
- A Step In The Right DirectionNPI 1003691544
- Able To ServeNPI 1437874864
- Alexander Youth NetworkNPI 1538737812
All 97 Mental Illness Community Based Residential Treatment Facility providers in Charlotte · All 32,379 providers in Charlotte
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.