KEWUAN DESHAUN JACKSON NPI 1639300874

NPI Information

Kewuan Deshaun Jackson is a respite care and mental illness and child respite care in Tucson, AZ. The provider is a facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental illness, as respite for the regular caregivers. Kewuan Deshaun Jackson NPI is 1639300874. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4880 N SABINO CANYON RD
APT 14160
TUCSON, AZ
ZIP 85750-006
Phone: (520) 818-4318

The enumeration date for this NPI number is 8/5/2009 and was last updated on 8/5/2009.

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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