CHARLESTON R JACKSON

WESTLAKE VILLAGE, CA
NPI1528288107
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2007-04-26
Last Update Date2007-07-08
Business Address
-- CHARLESTON R JACKSON
5655 LINDERO CANYON RD STE 302
WESTLAKE VILLAGE, CA 91362-4045
Phone number: 818-997-6876
Mailing Address
-- CHARLESTON R JACKSON
8031 SEPULVEDA BLVD APT 33
VAN NUYS, CA 91402-4432
Phone number:
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