NPI 1144196387

Antoinette Rae Jackson

Practitioner Mental Illness Community Based Residential Treatment Facility Milwaukee, WI

Practice location

Address: 3925 N 6th St, Milwaukee, WI 53212-1139
Phone: (414) 234-7720
Mailing address: PO Box 43, Mequon, WI 53092-0043

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X

Other Community Based Residential Treatment Facility, Mental Illness providers in Wisconsin →

Registry record

NPI: 1144196387
Entity type: Individual
Sex (as registered): Female
NPI issued: 15 Oct 2025
Record last updated: 15 Oct 2025

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.