Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jackson Group Home LLC

Organization Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · NPI 1588946370

Jackson Group Home LLC is an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Hannibal, Missouri. Licensed in Missouri. Registered with an NPI since 2011.

Licensed in
MO
In the registry since
2011
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

18 Ridgewood Dr
Hannibal, 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 · Licence 2500-12463 (MO)

Record details

NPI number1588946370
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lora Culp — Owner/Operator · (573) 221-4671
Other names Jackson Group Home
NPI enumeratedSeptember 16, 2011
Last updated in NPPESApril 9, 2017
Mailing address18 Ridgewood Dr, Hannibal, MO 63401-3056

Other providers in Hannibal