DC Jackson LLC
NPI #1265264857 in Taos, New Mexico
Provider Information
- NPI Number
- 1265264857
- Entity Type
- Organization
- Organization Name
- DC Jackson LLC
- Primary Specialty
- Clinic/Center - Adult Mental Health
- Enumeration Date
- Aug 14, 2024
- Last Updated
- Aug 14, 2024
Practice Location
- Address
- 25 GRIZZLY BEAR RUN RD
- City
- Taos
- State
- New Mexico
- ZIP Code
- 87571
- Phone
- (505) 523-0066
Authorized Official
- Name
- CHARITY JACKSON, MS, LPC-S, LPCC
- Title
- OWNER
- Phone
- (940) 220-1684
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
| Clinic/Center - Adult Mental Health — Adult Mental Health |
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