Organization
D MICHELE JACKSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA M. JACKSON (REGISTERED. NURSE)
(205) 502-7261
Entity
Organization
Contact information
Practice address
2620 RIVER HAVEN LN, HOOVER, AL 35244-1273
(302) 391-4645
Mailing address
2620 RIVER HAVEN LN, HOOVER, AL 35244-1273
(302) 391-4645
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
1150840
AL
Other
Enumeration date
06/27/2015
Last updated
06/27/2015
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