Individual provider · Type 1 NPI
Antoinette Rae Jackson
Mental Illness Community Based Residential Treatment Facility · Milwaukee, WI
NPI number
1144196387
Active
Practice location
3925 N 6th St
Milwaukee, WI 53212-1139
Mailing address
PO Box 43
Mequon, WI 53092-0043
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Illness Community Based Residential Treatment Facility Primary | 320800000X | None listed |
Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Other mental illness community based residential treatment facility providers in Milwaukee
About NPI 1144196387
Antoinette Rae Jackson's National Provider Identifier is 1144196387, issued on Oct 15, 2025. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Milwaukee, WI. The record was last updated on Oct 15, 2025.