Organization
JACKSON FAMILY HOMES, INC.
Active
Parent organization
JACKSON FAMILY HOME, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
JACKSON FAMILY HOME, INC.
Authorized official
DR. ROSEMARY HELEN JACKSON PH.D. (PRES/CEO)
(704) 905-5577
Entity
Organization
Contact information
Practice address
11808 PROVINCETOWNE DR, CHARLOTTE, NC 28277-9165
(704) 905-5577
(704) 846-2295
Mailing address
11808 PROVINCETOWNE DR, CHARLOTTE, NC 28277-9165
(704) 905-5577
(704) 846-2295
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6603584
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301582
—
NC
Enumeration date
07/26/2007
Last updated
07/26/2007
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