Individual
MR. ANDRE LEE JACKSON
Active
Individual
MR. ANDRE LEE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
342000000X
Transportation Network Company
—
—
3747P1801X
Personal Care Attendant
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
07/06/2026
Last updated
07/06/2026
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