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NPI Profile for JACQUENETT JACKSON in SHUBUTA, MS.
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Adult Care Home |
311ZA0620X |
| NPI # | 1376727388 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 12/27/2007 | |
| Last updated | 12/27/2007 - About 18 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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JACQUENETT JACKSON