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Organization
LIFESPAN PSYCHIATRIC CARE
Active
Organization
LIFESPAN PSYCHIATRIC CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS J JACKSON PMHNP-BC, ARNP (OWNER)
(561) 307-7745
Entity
Organization
Contact information
Practice address
4800 LINTON BLVD STE D502A, DELRAY BEACH, FL 33445-6593
(561) 808-7205
(561) 584-6804
Mailing address
701 S OLIVE AVE APT 407, WEST PALM BEACH, FL 33401-6195
(561) 307-7745
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
9294269
FL
Other
Enumeration date
08/23/2017
Last updated
08/23/2017
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