NPI 1285838805

Jackson Home, INC.

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Fairmont, NC

Practice location

Address: 509 Holly St, Fairmont, NC 28340-1705
Phone: (910) 628-7171

Authorised official

Name: Glenda T Jackson
Title: Director
Phone: (910) 628-7171

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X Licence MHL078158 (NC)

Other Residential Treatment Facility, Emotionally Disturbed Children providers in North Carolina →

Registry record

NPI: 1285838805
Entity type: Organization
NPI issued: 14 Jun 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.