| NPI | 1639247463 |
|---|---|
| Other Name | MELVIN JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 385HR2055X Respite Care Respite Care, Mental Illness, Child (Licence: AZ 10017) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2007-07-08 |