Lashaunda Louise Jackson in Portland - Community Based Residential Treatment Facility, Mental Illness
Lashaunda Louise Jackson - NPI 1326186271
Lashaunda Louise Jackson is a Community Based Residential Treatment Facility, Mental Illness in Portland, Oregon. Lashaunda Louise Jackson practices all healthcare services and medical treatments related to Community Based Residential Treatment Facility, Mental Illness. The NPI Number for Lashaunda Louise Jackson is 1326186271. The last update date is 2009-12-14.
Lashaunda Louise Jackson's current location address is 12942 Se Mitchell St, Portland, Oregon. You can contact this provider via phone number 5037543088. The mailing address for Lashaunda Louise Jackson is 12942 Se Mitchell St, Portland, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Lashaunda Louise Jackson |
|---|---|
| Address | 12942 Se Mitchell St, Portland, Oregon |
| Phone Number | 5037543088 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1326186271 |
|---|---|
| Provider Enumeration Date | 2007-02-02 |
| Last Updated Date | 2009-12-14 |
Provider Mailing Address Detail
| Address | 12942 Se Mitchell St |
|---|---|
| City | Portland |
| State | Oregon (OR) |
| Post Code | 972364151 |
| Phone Number | 5037543088 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
|---|---|
| Taxonomy | 320800000X |
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Definition: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
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What is the unique 10-digit identification code assigned to Lashaunda Louise Jackson by the Centers for Medicare & Medicaid Services?
The Lashaunda Louise Jackson has been issued the NPI (National Provider Identifier) 1326186271, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Lashaunda Louise Jackson is located?
The Lashaunda Louise Jackson is situated at the following address: 12942 Se Mitchell St, Portland, OR, 972364151.
What is Lashaunda Louise Jackson's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Lashaunda Louise Jackson is Community Based Residential Treatment Facility, Mental Illness, and the taxonomy classification code that categorizes this area of expertise is 320800000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1326186271 to Lashaunda Louise Jackson?
The Centers for Medicare & Medicaid Services originally issued the 1326186271 to Lashaunda Louise Jackson on 2007-02-02.
As of what date was the information regarding Lashaunda Louise Jackson, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Lashaunda Louise Jackson, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2009-12-14.
NPI Number: 1083611107
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