| Jackson Family Care Home Ii | |
|
7112 Outrigger Dr Wendell NC 27591-7240 | |
| (919) 366-1513 | |
| (919) 366-1513 |
| Full Name | Jackson Family Care Home Ii |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 7112 Outrigger Dr, Wendell, North Carolina |
| Authorized Official Name and Position | Mary Mccullers Jackson (OWNER/ADMINISTRATOR) |
| Authorized Official Contact | 9192665291 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Family Care Home Ii 5641 Quail Covey Ln Wendell NC 27591-7901 Ph: (919) 266-5291 | Jackson Family Care Home Ii 7112 Outrigger Dr Wendell NC 27591-7240 Ph: (919) 366-1513 |
| NPI Number | 1588808240 |
|---|---|
| Provider Enumeration Date | 04/26/2009 |
| Last Update Date | 04/26/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588808240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | FCL092148 (North Carolina) | Primary |
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