Jackson'S Personal Care

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

121013781 Issued in GA

Legal business name

JACKSON'S PERSONAL CARE

Practice address

2377 Dublin Dr
Augusta, GA 30906-4020

Phone

(706) 798-2127

Fax

(706) 496-7305

NPI assigned

Nov 16, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Velma L Jackson

Title

Owner

Phone

(706) 793-6487

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289865600000",
    "number": "1992006365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2377 DUBLIN DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309064020",
            "telephone_number": "706-798-2127",
            "fax_number": "706-496-7305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2377 DUBLIN DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309064020",
            "telephone_number": "706-798-2127",
            "fax_number": "706-496-7305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON'S PERSONAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-16",
        "last_updated": "2010-11-16",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "VELMA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-793-6487",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "GA",
            "license": "121013781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Jackson
• Shanequa Jackson
• Tasha Jackson, LMT
• Tiffaney S. Jackson, M.D.
• Tonjanika Jackson, PHD
• Jacksons Counseling Services
• Jacksons Counseling Services LLC
• Chequitta Jacobs, BSW
• Grace Babette Jacobs, MD
• Jeremy Michael Jacobs, MD

• All providers in Augusta, GA
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; 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.