Jackson Group Home LLC
Jackson Group Home LLC is an Intellectual and/or Developmental Disabilities Residential Treatment Facility in Hannibal, Missouri. Licensed in Missouri. Registered with an NPI since 2008.
- Licensed in
- MO
- In the registry since
- 2008
- Specialties on file
- 2
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
18 Ridgewood DrHannibal, MO 63401-3056
Phone: (573) 221-4671
Fax: (573) 221-4671
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (primary) | Taxonomy 320900000X (MO) |
|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | Taxonomy 320600000X |
Record details
| NPI number | 1487890786 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Lora Culp — Owner/Operator · (573) 221-4671 |
| NPI enumerated | December 17, 2008 |
| Last updated in NPPES | April 9, 2017 |
| Mailing address | 18 Ridgewood Dr, Hannibal, MO 63401-3056 |
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