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1316118342
DESHAWN JACKSON
LITTLE ROCK, AR
NPI
1316118342
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2008-03-18
Last Update Date
2008-03-18
Business Address
-- DESHAWN JACKSON
20400 COLONEL GLENN RD
LITTLE ROCK, AR 72210-5323
Phone number: 501-821-5500
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Mailing Address
-- DESHAWN JACKSON
522 E 23RD ST
LITTLE ROCK, AR 72206-2423
Phone number:
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