Jack 1 Foundation Inc.

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

JACK 1 FOUNDATION INC.

Doing business as

Golden Triangle Adult Day Care

Practice address

235 Procter St.
Port Arthur, TX 77640

Phone

(409) 984-5720

Fax

(409) 984-5720

NPI assigned

May 21, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Judyette Jackson

Title

Founder/Director

Phone

(409) 719-7003

Specialties & licenses 3

Addresses

Other names 1

• Golden Triangle Adult Day Care Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1400630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400630400000",
    "number": "1396157681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 PROCTER ST.",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "77640",
            "telephone_number": "409-984-5720",
            "fax_number": "409-984-5720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 PROCTER ST.",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "77640",
            "telephone_number": "409-984-5720",
            "fax_number": "409-984-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK 1 FOUNDATION INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-21",
        "last_updated": "2014-05-21",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JUDYETTE",
        "authorized_official_title_or_position": "FOUNDER/DIRECTOR",
        "authorized_official_telephone_number": "409-719-7003",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Golden Triangle Adult Day Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Infinite Care Solutions LLC
• Eldridge Inman
• Inpatient Consultants of Texas, PLLC
• Trisha Renee Irwin, OTR/L
• Mohammed Amirul Islam, MD
• Aledra Mesharn Jacobs, LPC-A
• Elissa Michelle Jacobs
• Jermaine Jacobs
• Deepti Jaggari, DMD
• Brandon Jaime

• Adult Day Care Clinic/Center in Port Arthur, TX
• Providers in Port Arthur, TX by specialty
• Adult Day Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.