Jackson's Group Home
NPI #1467575357 in New Madrid, Missouri
Provider Information
- NPI Number
- 1467575357
- Entity Type
- Organization
- Organization Name
- Jackson's Group Home
- Primary Specialty
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Apr 7, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 7570 US HIGHWAY 61
- City
- New Madrid
- State
- Missouri
- ZIP Code
- 63869-9183
- Phone
- (573) 688-2228
Authorized Official
- Name
- MRS. EARNESTINE JACKSON
- Title
- ADMINISTRATOR
- Phone
- (573) 688-2228
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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