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Contact Information

CYNTHIA R JACKSON
1206 W CENTRAL AVE
COOLIDGE, AZ85128-9165
 Phone: 480-886-9693
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Home Health Aide

374U00000X
 

Home Health

251E00000X A4[11] Home Health Agency
 

Homemaker

376J00000X
 

Respite Care

385H00000X
Indicates primary specialty

NPI Profile & details for CYNTHIA R JACKSON · (Female)

NPI # 1134759863
Status Active
Credentials
Entity Individual
Enumeration date 01/22/2020
Last updated 01/22/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • Other 468301 AHCCCS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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