Organization
JACKSON STYLE ADULT DAY CARE
Active
Parent organization
JACKSON STYLE LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
JACKSON STYLE LLC
Authorized official
MR. CLEOTHA JACKSON (ADMINISTRATIVE ASSISTANT)
(816) 769-8565
Entity
Organization
Contact information
Practice address
12707 2ND ST, GRANDVIEW, MO 64030-2207
(816) 763-1078
(816) 765-9987
Mailing address
12707 2ND ST, GRANDVIEW, MO 64030-2207
(816) 763-1078
(816) 765-9987
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
734
MO
Other
Enumeration date
01/15/2008
Last updated
01/15/2008
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