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1801254461
DEBORAH JACKSON
GARY, IN
NPI
1801254461
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
320800000X Community Based Residential Treatment Facility, Mental Illness
Enumeration Date
2016-02-10
Last Update Date
2016-02-10
Business Address
-- DEBORAH JACKSON
1100 W 6TH AVE
GARY, IN 46402
Phone number: 219-885-4264
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Mailing Address
-- DEBORAH JACKSON
1100 W 5TH AVE
GARY, IN 46402
Phone number: 219-885-4264
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