LEROY JACKSON

LANCASTER, CA
NPI1891900155
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2007-05-11
Last Update Date2007-07-08
Business Address
-- LEROY JACKSON
45335 SIERRA HWY
LANCASTER, CA 93534-1611
Phone number: 661-949-8599
Mailing Address
-- LEROY JACKSON
45335 SIERRA HWY
LANCASTER, CA 93534-1611
Phone number: 661-949-8599
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