# JACKSON'S HOMES LLC

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

## Provider details

- **NPI number:** 1487340808
- **Authorized official:** CORRISSA WEAVEER (OWNER)
- **Authorized official phone:** (586) 557-3413

## Contact information

- **Practice address:** 16160 BAYLIS ST, DETROIT, MI 48221-3101
- **Practice address phone:** (586) 557-3413
- **Mailing address:** 16160 BAYLIS ST, DETROIT, MI 48221-3101
- **Mailing address phone:** (586) 557-3433

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 04/18/2023
- **Last updated:** 11/16/2023