IREE JACKSON

TALLULAH, LA
NPI1275991176
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: LA  823)
Enumeration Date2016-02-05
Last Update Date2016-02-05
Business Address
-- IREE JACKSON LAC
404 E CRAIG ST
TALLULAH, LA 71282-3718
Phone number: 318-574-4164
Mailing Address
-- IREE JACKSON LAC
815 W CRAIG STREET
TALLULAH, LA 71282
Phone number: 318-574-4776
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