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

Melvin Jackson

Individual provider Emotionally Disturbed Childrens' Residential Treatment Facility · NPI 1831336411

Melvin Jackson is an Emotionally Disturbed Childrens' Residential Treatment Facility in Avondale, Arizona. Practices as a sole proprietor. Licensed in Arizona.

Licensed in
AZ
In the registry since
2009

Practice location Address checks out

2415 N 124th Cir
Avondale, AZ 85392-6509
Phone: (602) 841-3438
Show map & directions

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

Specialties & licences

Emotionally Disturbed Childrens' Residential Treatment Facility (primary) Taxonomy 322D00000X · Licence 11297 (AZ)

Record details

NPI number1831336411
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 19, 2009
Last updated in NPPESJanuary 19, 2009
Mailing address2415 N 124th Cir, Avondale, AZ 85392-6509

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