Tyshawn L Jackson
Tyshawn L Jackson is an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Omaha, Nebraska. Practices as a sole proprietor. Registered with an NPI since 2025.
- In the registry since
- 2025
Practice location Address checks out
1805 N 73rd StOmaha, NE 68114-1905
Phone: (402) 557-8583
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Specialties & licences
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (primary) | Taxonomy 320900000X |
|---|
Record details
| NPI number | 1992696769 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | July 10, 2025 |
| Last updated in NPPES | July 10, 2025 |
| Certification date | July 10, 2025 |
| Mailing address | 7719 Howell St, Omaha, NE 68122-2059 |
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