Mardell Jackson

NPI #1598247009 in Lake City, Florida

Provider Information

NPI Number
1598247009
Entity Type
Individual
Name
Mardell Jackson
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Assisted Living Facility
Enumeration Date
Aug 30, 2018
Last Updated
Aug 30, 2018

Practice Location

Address
197 NW GWEN LAKE AVE
State
Florida
ZIP Code
32055-3711
Phone
(386) 697-9425

Specialties & Taxonomy Codes

Specialty
Assisted Living Facility

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