Organization
JACKSON PERSONAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY JACKSON (OWNER)
(662) 303-6959
Entity
Organization
Contact information
Practice address
117 STONEWALL DR, INDIANOLA, MS 38751-2240
(662) 303-6959
Mailing address
117 STONEWALL DR, INDIANOLA, MS 38751-2240
(662) 303-6959
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
03/28/2020
Last updated
07/24/2020
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