Organization
MLJ ENTERPRISES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCUS JACKSON (PRESIDENT)
(972) 375-3608
Entity
Organization
Contact information
Practice address
916 JAMIE DR, GRAND PRAIRIE, TX 75052-2735
(469) 471-6695
Mailing address
PO BOX 224221, DALLAS, TX 75222-4221
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/07/2023
Last updated
07/07/2023
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