Organization
JACQUELINE F JACKSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELINE JACKSON JACKSON (OWNER)
(419) 270-2592
Entity
Organization
Contact information
Practice address
4207 SECOR RD APT 242, TOLEDO, OH 43623-4221
(419) 270-2592
Mailing address
4207 SECOR ROAD APT 242, TOLEDO, OH 43623
(419) 270-2592
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
SK455996
OH
253Z00000X
In Home Supportive Care Agency
SK455996
OH
Other
Enumeration date
02/07/2017
Last updated
02/07/2017
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