Jacquenett Jackson Valid NPI

Individual provider · Adult Care Home Facility · Shubuta, MS

NPI

1376727388

Type

Individual (Type 1)

Primary specialty

Adult Care Home Facility (Custodial Care Facility)

Specialty group

Nursing & Custodial Care Facilities

Taxonomy code

311ZA0620X

Sex

Female

Sole proprietor

Yes

Enumerated

2007-12-27

Last updated

2007-12-27