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Organization
JACKSON CASEMANAGEMENTAND SUPPORT COORDINATION SERVICES
Active
Organization
JACKSON CASEMANAGEMENTAND SUPPORT COORDINATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TEMPEST JACKSON (OWNER)
(985) 399-3263
Entity
Organization
Contact information
Practice address
190 HIGHWAY 90, PO 1349, PATTERSON, LA 70392-4246
(985) 399-3236
Mailing address
190 HIGHWAY 90, PO BOX 1349, PATTERSON, LA 70392-4246
(985) 399-3263
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
CM27006
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1348945
—
LA
Enumeration date
11/17/2009
Last updated
11/17/2009
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