Jackson's Group Home

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

JACKSON'S GROUP HOME

Practice address

7570 US Highway 61
New Madrid, MO 63869-9183

Phone

(573) 688-2228

Fax

(537) 688-5174

NPI assigned

Apr 7, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Earnestine Jackson

Title

Administrator

Phone

(573) 688-2228

Specialties & licenses 1

Addresses

Other names 1

• Personal Touch Other name

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

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467575357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7570 US HIGHWAY 61",
            "city": "NEW MADRID",
            "state": "MO",
            "postal_code": "638699183",
            "fax_number": "537-688-5174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7570 US HIGHWAY 61",
            "city": "NEW MADRID",
            "state": "MO",
            "postal_code": "638699183",
            "telephone_number": "573-688-2228",
            "fax_number": "537-688-5174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON'S GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "EARNESTINE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "573-688-2228",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Personal Touch",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Health Facilities Rehab Services Inc
• Heart2Help
• Charlotte Ann Hogan, SLP
• Sierra Elaine Holiman, APRN
• Lanikki Jackson
• Deondray D Jenkins
• Jamie Lynn Kimball, SLP
• Krewzin Transportation Services
• Tricia Lynn McClarty, OTR/L
• Missouri Delta Medical Center (New Madrid Community Care Center)

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in New Madrid, MO
• Providers in New Madrid, MO by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.