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1588932164
ANDREW JACKSON JACKSON
SACRAMENTO, CA
NPI
1588932164
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2011-12-09
Last Update Date
2011-12-09
Business Address
Mr. ANDREW JACKSON JACKSON
4441 AUBURN BLVD
SACRAMENTO, CA 95841-4139
Phone number: 916-473-5764
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Mailing Address
Mr. ANDREW JACKSON JACKSON
4441 AUBURN BLVD STE E
SACRAMENTO, CA 95841-4139
Phone number: 916-473-5764
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