JACQUENETT JACKSON

SHUBUTA, MS
NPI1376727388
Other NameANNETTE SMITH
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy311ZA0620X Custodial Care Facility, Adult Care Home
Enumeration Date2007-12-27
Last Update Date2007-12-27
Business Address
Mrs. JACQUENETT JACKSON
114 SECOND STREET
SHUBUTA, MS 39360
Phone number: 601-687-1128
Mailing Address
Mrs. JACQUENETT JACKSON
PO BOX 462
SHUBUTA, MS 39360-0462
Phone number: 601-687-1128