Jackson, John T

Jackson, John T is an individual health care provider with primary practice located at 13575 Lesure St , Detroit MI 48227-3131. 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, John T can be contacted via phone (313) 493-4410.

Contact Information

Primary practice address
13575 Lesure St Detroit MI 48227-3131
Phone: (313) 493-4410
Fax: (313) 493-4415
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1407986037
LBN Legal business name Jackson, John T
Credentials CAC-1
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 6th, 2007
Last updated Jul 8th, 2007 - about 17 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.

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