Individual
MS. CELIA ANDERSON JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2441 ATLAS ROAD, COLUMBIA, SC 29209-9744
(404) 803-3805
Mailing address
127 LATEESHA RD, HOPKINS, SC 29061-9744
(803) 875-1896
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
251E00000X
Home Health Agency
—
—
311ZA0620X
Adult Care Home Facility
—
—
3747A0650X
Attendant Care Provider
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
09/29/2022
Last updated
12/04/2024
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