Jackson Group Home Llc

LBN: Jackson Group Home Llc
Jackson Group Home Llc is an health care organization with primary practice located at 18 Ridgewood Dr , Hannibal MO 63401-3056. The organization recently has 2 registered licenses in different health care specialties including Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities. Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities is the primary health care specialty. Jackson Group Home Llc can be contacted via phone (573) 221-4671, or through Culp, Lora L via phone (573) 221-4671.

Contact Information

Primary practice address
18 Ridgewood Dr Hannibal MO 63401-3056
Phone: (573) 221-4671
Fax: (573) 221-4671
Website:
Map and Directions
Authorized official contact:
Name: Culp, Lora L BSN, RN
Phone: (573) 221-4671

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X Missouri

Profile Details

NPI number 1487890786
LBN Legal business name Jackson Group Home Llc
DBA Doing business as
Authorized official Culp, Lora L BSN, RN
Entity Organization
Organization subpart 1 No
Enumeration date Dec 17th, 2008
Last updated Apr 9th, 2017 - about 8 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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