Individual
VIRGIL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2507 N 187TH AVE, ELKHORN, NE 68022-4539
(918) 304-9225
Mailing address
4805 N 72ND ST, OMAHA, NE 68134-2304
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
NE
Other
Enumeration date
05/06/2026
Last updated
05/06/2026
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