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Contact Information

BIANCA J JACKSON
2508 SHANNON CT
HEPHZIBAH, GA30815-6633
 Phone: 706-284-1533
 Fax: 706-284-1533
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

In Home Supportive Care

253Z00000X
 

Residential Treatment Facility, Physical Disabilities

320700000X
Indicates primary specialty

NPI Profile & details for

NPI Number 1992387823
Entity Organization
Organization subpart 1 Not specified
Enumeration date 04/21/2021
Last updated 04/10/2022 - About 4 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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