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

Organization Intellectual and/or Developmental Disabilities Residential Treatment Facility · NPI 1386701613

Jackson Style Agency, LLC is an Intellectual and/or Developmental Disabilities Residential Treatment Facility in Grandview, Missouri. Registered with an NPI since 2007.

In the registry since
2007
Specialties on file
2
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

213 Blue Ridge Ext
Grandview, MO 64030-1603
Phone: (816) 765-9990
Fax: (816) 765-9987
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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
Intellectual and/or Developmental Disabilities Residential Treatment Facility Taxonomy 320600000X

Record details

NPI number1386701613
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Cleotha Jackson — Assistant Administrator · (816) 765-9990
NPI enumeratedJanuary 3, 2007
Last updated in NPPESJuly 10, 2007
Mailing address213 Blue Ridge Ext, Grandview, MO 64030-1603

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