RUSSELL L JACKSON

CLEVELAND, OH
NPI1396218418
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy251S00000X Community/Behavioral Health
Additional Taxonomies171M00000X Case Manager/Care Coordinator
Enumeration Date2019-01-11
Last Update Date2019-01-11
Business Address
RUSSELL L JACKSON QMHS BA CMS BA
3500 CARNEGIE AVE
CLEVELAND, OH 44115-2641
Phone number: 440-260-8300
Mailing Address
RUSSELL L JACKSON QMHS BA CMS BA
434 EASTLAND RD
BEREA, OH 44017-1217
Phone number: 440-234-2006
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