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Organization

JACKSON'S PERSONAL CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. VELMA L JACKSON (OWNER)
(706) 793-6487
Entity
Organization

Contact information

Practice address
2377 DUBLIN DR, AUGUSTA, GA 30906-4020
(706) 798-2127
(706) 496-7305
Mailing address
2377 DUBLIN DR, AUGUSTA, GA 30906-4020
(706) 798-2127
(706) 496-7305

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
121013781
GA

Other

Enumeration date
11/16/2010
Last updated
11/16/2010
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