Organization · Type 2 NPI

Jackson Group Home LLC

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Hannibal, MO

NPI number 1487890786 Active

Practice location

18 Ridgewood Dr
Hannibal, MO 63401-3056

Call (573) 221-4671 Map

Fax (573) 221-4671

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000XNone listed
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary 320900000XNone 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.

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About NPI 1487890786

Jackson Group Home LLC's National Provider Identifier is 1487890786, issued on Dec 17, 2008. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Hannibal, MO. The record was last updated on Apr 9, 2017.