Jackson Group Home in Alexandria - Intermediate Care Facility, Intellectual Disabilities
Jackson Group Home - NPI 1598784647
Jackson Group Home is a Intermediate Care Facility, Intellectual Disabilities in Alexandria, Louisiana. Jackson Group Home practices all healthcare services and medical treatments related to Intermediate Care Facility, Intellectual Disabilities. The NPI Number for Jackson Group Home is 1598784647. The last update date is 2009-11-07.
Jackson Group Home's current location address is 325 Mckeithen Drive, Alexandria, Louisiana. You can contact this provider via phone number 3184730217 and fax number 3184730256. The mailing address for Jackson Group Home is 325 Mckeithen Drive, Alexandria, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Jackson Group Home |
|---|---|
| Address | 325 Mckeithen Drive, Alexandria, Louisiana |
| Phone Number | 3184730217 |
| Fax Number | 3184730256 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | ADMINISTRA |
|---|---|
| Authorized Official Name | Bolton Bonnette Christina |
| Telephone Number | 3184451551 |
NPI Number Detail
| NPI Number | 1598784647 |
|---|---|
| Provider Enumeration Date | 2006-07-19 |
| Last Updated Date | 2009-11-07 |
Provider Mailing Address Detail
| Address | 325 Mckeithen Drive |
|---|---|
| City | Alexandria |
| State | Louisiana (LA) |
| Post Code | 71303 |
| Phone Number | 3184730217 |
| Fax Number | 3184730256 |
Provider's Primary Taxonomy Detail
| Speciality | Intermediate Care Facility, Intellectual Disabilities |
|---|---|
| Taxonomy | 315P00000X |
| Licence No | 814 |
|
Definition: An intermediate care facility providing services for individuals with intellectual disabilities. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1713686 | LA | UNISYS |
Post Comment/ Review Below
What is the Jackson Group Home's 1598784647?
The Jackson Group Home's NPI (National Provider Identifier) Number is 1598784647. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Jackson Group Home is physically located?
The Jackson Group Home is situated at the following address: 325 Mckeithen Drive, Alexandria, LA 71303.
What is Jackson Group Home's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Jackson Group Home is Intermediate Care Facility, Intellectual Disabilities, and the taxonomy code that categorizes this field of expertise is 315P00000X.
On what date did the Jackson Group Home receive the assignment of its 1598784647 from the Centers for Medicare & Medicaid Services?
The Jackson Group Home was issued its 1598784647 by the Centers for Medicare & Medicaid Services on 2006-07-19.
As of what date was the information pertaining to Jackson Group Home, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Jackson Group Home, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2009-11-07.
NPI Number: 1215930425
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