NPI 1720421795

Albert Jackson, AODA

Practitioner Community/Behavioral Health Agency Milwaukee, WI

Practice location

Address: 4001 W Capitol Dr, Milwaukee, WI 53216-2530
Phone: (414) 810-6691
Mailing address: 4950 N 21st Street, Milwaukee, WI 53209-5750

Registered specialties (2)

Community/Behavioral Health Agency Primary

Agencies Taxonomy 251S00000X Licence 16862-130 (WI)

Other Community/Behavioral Health providers in Wisconsin →

Mental Health Clinic/Center (Including Community Mental Health Center)

Ambulatory Health Care Facilities Taxonomy 261QM0801X Licence 16862-130 (WI)

Other Clinic/Center providers in Wisconsin →

Registry record

NPI: 1720421795
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Apr 2013
Record last updated: 9 Apr 2013

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.