Organization
JACKSON FAMILY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY MCCULLERSJACKSON (OWNER ADMINISTRATOR)
(919) 266-5291
Entity
Organization
Contact information
Practice address
221 E BARBEE ST, ZEBULON, NC 27597-2811
(919) 404-0628
(919) 266-7901
Mailing address
5641 QUAIL COVEY LN, WENDELL, NC 27591-7901
(919) 266-5291
(919) 266-7901
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
FCL 092-120
NC
Other
Enumeration date
01/26/2007
Last updated
08/22/2020
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