JALISA JACKSON

CHARLOTTE, NC
NPI1366041667
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy320800000X Community Based Residential Treatment Facility, Mental Illness
(Licence: NC  MHL-036-348)
Enumeration Date2020-10-19
Last Update Date2020-10-19
Business Address
JALISA JACKSON
11413 MANGLA DR
CHARLOTTE, NC 28214-8885
Phone number: 704-819-4909
Mailing Address
JALISA JACKSON
11413 MANGLA DR
CHARLOTTE, NC 28214-8885
Phone number: 704-819-4909
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