KEVIN JACKSON

LOS ANGELES, CA
NPI1821647207
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2019-09-08
Last Update Date2019-09-08
Business Address
KEVIN JACKSON
8831 VENICE BLVD
LOS ANGELES, CA 90034-3223
Phone number: 310-204-5200
Mailing Address
KEVIN JACKSON
8831 VENICE BLVD
LOS ANGELES, CA 90034-3223
Phone number:
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