Individual provider · Type 1 NPI
Marcus S. Jackson Sr.
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Pensacola, FL
Practice location
5615 Shell Rd
Pensacola, FL 32503-7825
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | None listed |
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
About NPI 1336767128
Marcus S. Jackson Sr.'s National Provider Identifier is 1336767128, issued on Jul 8, 2020. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Pensacola, FL. The record was last updated on Jul 8, 2020.