Individual
CHARISSE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1927 MONROE ST, INDIANAPOLIS, IN 46229-1921
(317) 374-3323
Mailing address
1927 MONROE ST, INDIANAPOLIS, IN 46229-1921
(317) 374-3323
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
24-017916-1
IN
Other
Enumeration date
09/11/2024
Last updated
09/11/2024
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