NPI 1184557456

Kendall Jackson

Practitioner Substance Abuse Rehabilitation Facility Sugar Grove, WV

Practice location

Address: 133 Hedrick Dr, Sugar Grove, WV 26815-5068
Phone: (310) 910-0406

Registered specialties

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X

Other Substance Abuse Rehabilitation Facility providers in West Virginia →

Registry record

NPI: 1184557456
Entity type: Individual
Sex (as registered): Female
NPI issued: 5 Jun 2026
Record last updated: 5 Jun 2026

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.