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1922308550
MICHAEL JACKSON
BRONX, NY
NPI
1922308550
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY 19006)
Enumeration Date
2010-10-29
Last Update Date
2017-01-25
Business Address
Mr. MICHAEL JACKSON CASAC
1910 ARTHUR AVE
BRONX, NY 10457-6305
Phone number: 718-583-5150
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Mailing Address
Mr. MICHAEL JACKSON CASAC
1910 ARTHUR AVE
BRONX, NY 10457-6305
Phone number: 718-583-5150
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