Jackson, Early Lee
Jackson, Early Lee is an individual health care provider with primary practice located at 22639 Euclid Ave , Euclid OH 44117-1622. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Jackson, Early Lee can be contacted via phone (216) 404-1900.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 175805 | Ohio |
Profile Details
| NPI number | 1427627744 |
|---|---|
| LBN Legal business name | Jackson, Early Lee |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 21st, 2021 |
| Last updated | Jun 21st, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427627744 | NPPES |
| Ohio | MEDICAID | 175805 |
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