Jackson Home, Inc.

LBN: Jackson Home, Inc.
Jackson Home, Inc. is an health care organization with primary practice located at 509 Holly St , Fairmont NC 28340-1705. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children, which is considered as the primary health care specialty. Jackson Home, Inc. can be contacted via phone (910) 628-7171, or through Jackson, Glenda T via phone (910) 628-7171.

Contact Information

Primary practice address
509 Holly St Fairmont NC 28340-1705
Phone: (910) 628-7171
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Jackson, Glenda T
Phone: (910) 628-7171

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X MHL078158 North Carolina

Profile Details

NPI number 1285838805
LBN Legal business name Jackson Home, Inc.
DBA Doing business as
Authorized official Jackson, Glenda T
Entity Organization
Organization subpart 1 No
Enumeration date Jun 14th, 2007
Last updated Aug 22nd, 2020 - about 4 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 1285838805 NPPES
North Carolina MEDICAID 6603889

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