Organization
JACKSON HEALTHCARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JE-JE W JACKSON (OWNER/PROGRAM MANAGER)
(904) 428-3182
Entity
Organization
Contact information
Practice address
5604 ASHLEIGH PARK DR, JACKSONVILLE, FL 32244-7821
(190) 442-8318
Mailing address
5604 ASHLEIGH PARK DR, JACKSONVILLE, FL 32244-7821
(190) 442-8318
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013844800
—
FL
Enumeration date
04/02/2021
Last updated
04/02/2021
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