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

Tedra Jackson

Individual provider Developmentally Disabled Services Day Training Agency · NPI 1255211447

Tedra Jackson is a Developmentally Disabled Services Day Training Agency in Cleveland, Ohio. Practices as a sole proprietor. Licensed in Ohio.

Licensed in
OH
In the registry since
2025
Specialties on file
5

Practice location Address checks out

782 E 130th St
Cleveland, OH 44108-2544
Phone: (216) 334-3163
Show map & directions

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

Specialties & licences

Personal Care Attendant (primary) Taxonomy 3747P1801X (OH)
Developmentally Disabled Services Day Training Agency Taxonomy 251C00000X (OH)
Supports Brokerage Agency Taxonomy 251X00000X (OH)
In Home Supportive Care Agency Taxonomy 253Z00000X (OH)
Home Delivered Meals Taxonomy 332U00000X (OH)

Record details

NPI number1255211447
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 8, 2025
Last updated in NPPESSeptember 8, 2025
Certification dateSeptember 7, 2025

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