Individual
JE-JE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5604 ASHLEIGH PARK DR, JACKSONVILLE, FL 32244-7821
(904) 428-3182
(904) 778-9707
Mailing address
5604 ASHLEIGH PARK DR, JACKSONVILLE, FL 32244-7821
(904) 428-3182
(904) 778-9707
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
12/16/2016
Last updated
12/20/2016
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