Jackson, Melody

Jackson, Melody is an sole proprietor health care provider with primary practice located at 1667 N Allison St , Philadelphia PA 19131-3530. She recently has 4 registered licenses in different health care specialties including Agencies / Home Health, Nursing Service Related Providers / Homemaker, Respite Care Facility / Respite Care, Agencies / In Home Supportive Care. Agencies / In Home Supportive Care is her primary health care specialty. Jackson, Melody can be contacted via phone (267) 658-9971.

Contact Information

Primary practice address
1667 N Allison St Philadelphia PA 19131-3530
Phone: (267) 658-9971
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Agencies / Home Health 251E00000X 61203601 Pennsylvania
Nursing Service Related Providers / Homemaker 376J00000X 61203601 Pennsylvania
Respite Care Facility / Respite Care 385H00000X 61203601 Pennsylvania
Agencies / In Home Supportive Care 253Z00000X 61203601 Pennsylvania

Profile Details

NPI number 1316601511
LBN Legal business name Jackson, Melody
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 25th, 2021
Last updated May 23rd, 2022 - about 2 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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Identifiers

StateTypeNumberIssuer
All States NPI 1316601511 NPPES
Pennsylvania MEDICAID 61203601

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