Jackson, Ladonna
Jackson, Ladonna is an sole proprietor health care provider with primary practice located at 1866 N Marble Ridge Pl , Tucson AZ 85715-4574. She recently has 2 registered licenses in different health care specialties including Respite Care Facility / Respite Care, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness. Respite Care Facility / Respite Care is her primary health care specialty. Jackson, Ladonna can be contacted via phone (520) 722-9296.Contact Information
Primary practice address
1866 N Marble Ridge Pl
Tucson AZ 85715-4574
Phone: (520) 722-9296
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respite Care Facility / Respite Care | 385H00000X | BH4932 | Arizona |
| Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness | 320800000X | BH-2808 | Arizona |
Profile Details
| NPI number | 1518032945 |
|---|---|
| LBN Legal business name | Jackson, Ladonna |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 21st, 2006 |
| Last updated | Jul 27th, 2020 - about 4 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 | 1518032945 | NPPES |
| Arizona | Other | BH4932 | AZ DEPT OF HEALTH SERVICES |
| Arizona | MEDICAID | 764721 | AZ DEPT OF HEALTH SERVICES |
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