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Organization
JACKSON HOME HEALTH
Active
Organization
JACKSON HOME HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHONTIA LATOYIA GRAY (OWNER/MANAGER)
(318) 789-4272
Entity
Organization
Contact information
Practice address
111 PECAN LAKE ESTATE RD, MONROE, LA 71203-9383
(318) 789-4272
Mailing address
111 PECAN LAKE ESTATE RD, MONROE, LA 71203-9383
(318) 789-4272
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
—
LA
Other
Enumeration date
07/24/2015
Last updated
09/12/2015
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