| NPI | 1740489517 |
|---|---|
| Doing Business As | JACKSON STYLE AGENCY |
| Entity Type | Organization |
| Authorized Contact | CLEOTHA JACKSON Asst. Administrator 816-765-9990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2007-07-12 |