# JACKSON MANOR 1691 TENANT, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Jackson Manor Nursing & Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861491466
- **Authorized official:** MR. ALEX PALEY (COO)
- **Authorized official phone:** (914) 390-4363

## Contact information

- **Practice address:** 1691 S HUDSON AVE, JONESBORO, LA 71251-5856
- **Practice address phone:** (318) 259-7386
- **Practice address fax:** (318) 259-4644
- **Mailing address:** 1691 S HUDSON AVE, JONESBORO, LA 71251-5856
- **Mailing address phone:** (318) 259-7386
- **Mailing address fax:** (318) 259-4644

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 865 | LA | Yes |

## Other

- **Enumeration date:** 07/18/2005
- **Last updated:** 02/12/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1510726 | — | LA |