MR. Marcus S Jackson SR.

NPI #1336767128 in Pensacola, Florida

Provider Information

NPI Number: 1336767128
Entity Type: Individual
Name: MR. Marcus S Jackson SR.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Jul 8, 2020
Last Updated: Jul 8, 2020

Practice Location

Address: 5615 SHELL RD
City: Pensacola
State: Florida
ZIP Code: 32503-7825
Phone: (850) 791-6604

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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