Jackson Style Adult Day Care

NPI #1871779280 in Grandview, Missouri

Provider Information

NPI Number: 1871779280
Entity Type: Organization
Organization Name: Jackson Style Adult Day Care
Subpart: Yes (part of a larger organization)
Parent Organization: JACKSON STYLE LLC
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Jan 15, 2008
Last Updated: Jan 15, 2008

Practice Location

Address: 12707 2ND ST
City: Grandview
State: Missouri
ZIP Code: 64030-2207
Phone: (816) 763-1078

Authorized Official

Name: MR. CLEOTHA JACKSON
Title: ADMINISTRATIVE ASSISTANT
Phone: (816) 769-8565

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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