Jackson, Latoria Nicole

Jackson, Latoria Nicole is an sole proprietor health care provider with primary practice located at 4150 Alexis Ct , Loganville GA 30052-9070. She recently has 12 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Agencies / Case Management, Agencies / Day Training, Developmentally Disabled Services, Agencies / Community/Behavioral Health, Ambulatory Health Care Facilities / Adult Day Care, Ambulatory Health Care Facilities / Developmental Disabilities, Nursing & Custodial Care Facilities / Assisted Living, Mental Illness, 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, Nursing Service Related Providers / Adult Companion, Nursing Service Related Providers / Day Training/Habilitation Specialist, Transportation Services / Non-emergency Medical Transport (VAN). Transportation Services / Non-emergency Medical Transport (VAN) is her primary health care specialty. Jackson, Latoria Nicole can be contacted via phone (678) 671-0078.

Contact Information

Primary practice address
4150 Alexis Ct Loganville GA 30052-9070
Phone: (678) 671-0078
Fax: (888) 948-2083
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Agencies / Case Management 251B00000X
Agencies / Day Training, Developmentally Disabled Services 251C00000X
Agencies / Community/Behavioral Health 251S00000X
Ambulatory Health Care Facilities / Adult Day Care 261QA0600X
Ambulatory Health Care Facilities / Developmental Disabilities 261QD1600X
Nursing & Custodial Care Facilities / Assisted Living, Mental Illness 3104A0625X
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
Nursing Service Related Providers / Adult Companion 372600000X
Nursing Service Related Providers / Day Training/Habilitation Specialist 373H00000X
Transportation Services / Non-emergency Medical Transport (VAN) 343900000X

Profile Details

NPI number 1922500289
LBN Legal business name Jackson, Latoria Nicole
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 2nd, 2018
Last updated Mar 2nd, 2018 - about 6 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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