Individual
TAMIKA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24123 GREENFIELD RD # 311207, SOUTHFIELD, MI 48075-3125
(313) 457-4114
Mailing address
24123 GREENFIELD RD STE 311, SOUTHFIELD, MI 48075-3124
(313) 457-4114
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
311ZA0620X
Adult Care Home Facility
—
—
372500000X
Chore Provider
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
04/02/2024
Last updated
04/02/2024
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