Jackson, Melvin

Jackson, Melvin is an sole proprietor health care provider with primary practice located at 2415 N 124Th Cir , Avondale AZ 85392-6509. He recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children, which is considered as his primary health care specialty. Jackson, Melvin can be contacted via phone (602) 841-3438.

Contact Information

Primary practice address
2415 N 124Th Cir Avondale AZ 85392-6509
Phone: (602) 841-3438
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X 11297 Arizona

Profile Details

NPI number 1831336411
LBN Legal business name Jackson, Melvin
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 19th, 2009
Last updated Jan 19th, 2009 - about 15 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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