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1063096147
ANTWAIN JACKSON
DECATUR, AL
NPI
1063096147
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
373H00000X Day Training/Habilitation Specialist
Additional Taxonomies
372600000X Adult Companion
Enumeration Date
2021-05-05
Last Update Date
2021-05-05
Business Address
Mr. ANTWAIN JACKSON
1711 10TH AVE SE
DECATUR, AL 35601-4915
Phone number: 256-226-0150
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Mailing Address
Mr. ANTWAIN JACKSON
1711 10TH AVE SE
DECATUR, AL 35601-4915
Phone number: 256-226-0150
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