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

Antoinette Rae Jackson

Individual provider Mental Illness Community Based Residential Treatment Facility · NPI 1144196387

Antoinette Rae Jackson is a Mental Illness Community Based Residential Treatment Facility in Milwaukee, Wisconsin. Practices as a sole proprietor. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2025

Practice location Address checks out

3925 N 6th St
Milwaukee, WI 53212-1139
Phone: (414) 234-7720
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Illness Community Based Residential Treatment Facility (primary) Taxonomy 320800000X (WI)

Record details

NPI number1144196387
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 15, 2025
Last updated in NPPESOctober 15, 2025
Certification dateOctober 14, 2025
Mailing addressPo Box 43, Mequon, WI 53092-0043

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