C Wesley Jackson Jr Phd Inc

LBN: C Wesley Jackson Jr Phd Inc
C Wesley Jackson Jr Phd Inc is an health care organization with primary practice located at 2980 Washington Blvd , Cleveland Heights OH 44118-2450. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as the primary health care specialty. C Wesley Jackson Jr Phd Inc can be contacted via phone (216) 321-9355, or through Jackson, C Wesley via phone (216) 321-9355.

Contact Information

Primary practice address
2980 Washington Blvd Cleveland Heights OH 44118-2450
Phone: (216) 321-9355
Fax: (216) 932-3341
Website:
Map and Directions
Authorized official contact:
Name: Jackson, C Wesley PHD
Phone: (216) 321-9355

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 474 Ohio
Behavioral Health & Social Service Providers / Clinical 103TC0700X 000519 Michigan

Profile Details

NPI number 1720202500
LBN Legal business name C Wesley Jackson Jr Phd Inc
DBA Doing business as
Authorized official Jackson, C Wesley PHD
Entity Organization
Organization subpart 1 No
Enumeration date Apr 12th, 2007
Last updated Jul 30th, 2012 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720202500 NPPES
Ohio MEDICAID 0253309

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