Individual provider · Type 1 NPI
Nicole Jefferson
Physical Disabilities Residential Treatment Facility · Seguin, TX
NPI number
1174023063
Active
Practice location
529 Grayson Ln
Seguin, TX 78155-3084
Fax (830) 433-4219
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Assisted Living Facility (Mental Illness) | 3104A0625X | None listed |
| Adult Care Home Facility | 311ZA0620X | None listed |
| Mental Illness Community Based Residential Treatment Facility | 320800000X | None listed |
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | None listed |
| Physical Disabilities Residential Treatment Facility Primary | 320700000X | None listed |
| Adult Day Care Clinic/Center | 261QA0600X | None listed |
Physical Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently.
Another provider at this address
About NPI 1174023063
Nicole Jefferson's National Provider Identifier is 1174023063, issued on Feb 16, 2018. The primary taxonomy on file is Physical Disabilities Residential Treatment Facility (320700000X), and the practice location is in Seguin, TX. The record was last updated on Aug 13, 2023.