Individual provider · Type 1 NPI

Beverly Jackson

Mental Illness Community Based Residential Treatment Facility · Gary, IN

NPI number 1871902247 Active

Practice location

1100 W 6th Ave
Gary, IN 46402-1711

Call (219) 885-4264 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Illness Community Based Residential Treatment Facility Primary 320800000XNone 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.

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About NPI 1871902247

Beverly Jackson's National Provider Identifier is 1871902247, issued on Aug 10, 2014. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Gary, IN. The record was last updated on Aug 10, 2014.