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Organization
JACKSON SUPPORT SERVICES
Active
Organization
JACKSON SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATASHA JACKSON (OWNER)
(619) 846-5650
Entity
Organization
Contact information
Practice address
532 BUCKINGHAM PL, DESOTO, TX 75115-6111
(619) 846-5650
(619) 846-5659
Mailing address
532 BUCKINGHAM PL, DESOTO, TX 75115-6111
(619) 845-5650
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
311ZA0620X
Adult Care Home Facility
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
08/25/2021
Last updated
09/30/2021
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