Organization
JACKSON CONSULTING AND SERVICES LLC
Active
Organization
JACKSON CONSULTING AND SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL JACKSON MS,LCAS (OWNER)
(980) 353-6536
Entity
Organization
Contact information
Practice address
9008 BROAD RIDGE CT, CHARLOTTE, NC 28269-5199
(980) 353-6536
Mailing address
9008 BROAD RIDGE CT, CHARLOTTE, NC 28269-5199
(980) 353-6536
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34D2236576
—
NC
Enumeration date
09/21/2021
Last updated
07/25/2025
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