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Organization

LATOSHA JACKSON

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LATOSHA M JACKSON LIMHP, CMSW (LICENSED CLINICIAN SOCIAL WORKER)
(402) 469-6899
Entity
Organization

Contact information

Practice address
5539 S 27TH ST STE 104, LINCOLN, NE 68512-1600
(402) 261-8313
Mailing address
5539 S 27TH ST STE 104, LINCOLN, NE 68512-1600
(402) 261-8313

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)

Other

Enumeration date
04/04/2019
Last updated
04/04/2019
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