Jackson Group Home LLC
NPI #1588946370 in Hannibal, Missouri
Provider Information
- NPI Number
- 1588946370
- Entity Type
- Organization
- Organization Name
- Jackson Group Home LLC
- Primary Specialty
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Sep 16, 2011
- Last Updated
- Apr 9, 2017
Practice Location
Authorized Official
- Name
- MRS. LORA L CULP, BSN, RN
- Title
- OWNER/OPERATOR
- Phone
- (573) 221-4671
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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