Whalio Doctors

NPI 1417502998

Christopher Robert Jackson

Practitioner Emotionally Disturbed Childrens' Residential Treatment Facility North Pole, AK

Practice location

Address
1502 Liatris Ln, North Pole, AK 99705-5082
Phone
(907) 385-5733
Mailing address
1680 Midland St, North Pole, AK 99705-5881

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 322D00000X Licence 523381 (AK)

Registry record

NPI
1417502998
Entity type
Individual
Sex (as registered)
Male
NPI issued
1 Aug 2019
Record last updated
1 Aug 2019

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.