Jackson Home for Veterans

Primary specialty

Lodging ProviderTaxonomy code 177F00000X

Legal business name

JACKSON HOME FOR VETERANS

Practice address

2633 Juniper Dr
Charlotte, NC 28269-4004

Phone

(704) 315-7089

NPI assigned

Oct 20, 2020

Organization subpart

No

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

Authorized official

Name

Levar Lafayette Jackson

Title

Owner

Phone

(704) 315-7089

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603411200000",
    "number": "1467051631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2633 JUNIPER DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282694004",
            "telephone_number": "704-315-7089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2633 JUNIPER DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282694004",
            "telephone_number": "704-315-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON HOME FOR VETERANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "LEVAR",
        "authorized_official_middle_name": "LAFAYETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-315-7089"
    },
    "taxonomies": [
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Migrant Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Lynn Jackloski, MM, MS, CCC-SLP
• Sarah Kathleen Jacks, LPCA
• Jackson Consulting and Services LLC
• Jackson Family Homes, Inc.
• Jackson Family Homes, Inc.
• Diane O Jackson-Szymczyk, PT
• Yameka Jackson-Williams, OWNER
• Adrienne Jackson
• Alexis Jackson
• Alfred Manwuel Jackson, D.D.S., M.S.

• Lodging Provider in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Lodging Provider in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; 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.