Organization
THE VILLAGE CONSULTANT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELISSA FAYE JACKSON PH.D. (OWNER)
(205) 603-1411
Entity
Organization
Contact information
Practice address
5780 HERITAGE PARK DR, MC CALLA, AL 35111-3490
(205) 603-1411
Mailing address
350 CANYON PARK DR, PELHAM, AL 35124-4819
(205) 603-1411
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1322
AL
Other
Enumeration date
09/02/2010
Last updated
09/02/2010
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