MICHAEL JACKSON

BRONX, NY
NPI1922308550
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY  19006)
Enumeration Date2010-10-29
Last Update Date2017-01-25
Business Address
Mr. MICHAEL JACKSON CASAC
1910 ARTHUR AVE
BRONX, NY 10457-6305
Phone number: 718-583-5150
Mailing Address
Mr. MICHAEL JACKSON CASAC
1910 ARTHUR AVE
BRONX, NY 10457-6305
Phone number: 718-583-5150
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