# HAWANYA JACKSON

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407262447
- **Authorized official:** MS. HAWANYA ABENA JACKSON BA, RSST, QIDP (INDEPENDENT SUPPORT COORDINATOR)
- **Authorized official phone:** (313) 942-5230

## Contact information

- **Practice address:** 2425 ATKINSON ST, DETROIT, MI 48206-2057
- **Practice address phone:** (313) 942-5230
- **Mailing address:** 2425 ATKINSON ST, DETROIT, MI 48206-2057
- **Mailing address phone:** (313) 942-5230

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | 6803085548 | MI | Yes |

## Other

- **Enumeration date:** 07/10/2014
- **Last updated:** 07/10/2014