RODERICK O. JACKSON

HIGHLAND PARK, MI
NPI1801120779
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2009-09-25
Last Update Date2009-09-25
Business Address
Mr. RODERICK O. JACKSON C.P.S.S.
211 GLENDALE ST
HIGHLAND PARK, MI 48203-3231
Phone number: 313-459-4802
Mailing Address
Mr. RODERICK O. JACKSON C.P.S.S.
9176 DIXIE
REDFORD, MI 48239-1516
Phone number: 313-459-4802