Jackson Family Homes, INC.
Community/Behavioral Health in Charlotte, NC. Organization (NPI-2).
NPI number1629166327
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1629166327
- Entity type
- Organization (NPI-2)
- Legal business name
- Jackson Family Homes, INC.
- Organization subpart
- No
- Enumeration date
- Oct 10, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | 8301472 | NC | Yes |
Other names
- Jackson Support Services, INC (Other Name)
Practice location
11808 Provincetowne DrCharlotte, NC 28277-9165
Phone 704-846-2295 · Fax 704-332-3510
Mailing address
11808 Provincetowne DrCharlotte, NC 28277-9165
Phone 704-846-2295 · Fax 704-332-3510
Authorized official
Rosemary Helen Jackson
President/Ceo
7048462295
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