Mr. Marcus S Jackson Sr.
Mr. Marcus S Jackson Sr. is an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Pensacola, Florida. Practices as a sole proprietor. Registered with an NPI since 2020.
- In the registry since
- 2020
Practice location Address checks out
5615 Shell RdPensacola, FL 32503-7825
Phone: (850) 791-6604
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Specialties & licences
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (primary) | Taxonomy 320900000X |
|---|
Record details
| NPI number | 1336767128 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | July 8, 2020 |
| Last updated in NPPES | July 8, 2020 |
| Certification date | July 8, 2020 |
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