JACKSON FAMILY CARE HOME II NPI 1588808240

NPI Information

JACKSON FAMILY CARE HOME II is an adult mental health clinic center in Wendell, NC. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. JACKSON FAMILY CARE HOME II NPI is 1588808240. The provider is registered as an organization entity type.

The provider's business location address is:

7112 OUTRIGGER DR
WENDELL, NC
ZIP 27591-240
Phone: (919) 366-1513
Fax: (919) 366-1513

The provider's authorized official is Mary Mccullers Jackson .
The authorized official title is Owner/administrator and has the following contact phone number (919) 266-5291.

The enumeration date for this NPI number is 4/26/2009 and was last updated on 4/26/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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