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Stephanie Denise Jackson
Child Mental Illness Respite Care in Buckeye, Arizona
NPI 1003459934

Stephanie Denise Jackson is a Child Mental Illness Respite Care based in Buckeye, AZ and is specialized in Respite Care, Mental Illness, Child. Stephanie Denise Jackson practices in Buckeye, AZ. The NPI Number for Stephanie Denise Jackson is 1003459934 and holds a License No. 9911474 (Arizona).

The current practice location address for Stephanie Denise Jackson is 22321 W Morning Glory St, Buckeye, AZ and can be reached out via phone at 503-209-7572 and via fax at 602-455-4624.

Location: 22321 W Morning Glory St, Buckeye, AZ, 85326-7181
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003459934
Provider Name
Stephanie Denise Jackson
Credential
Provider Entity Type
Individual
Gender
Female
Address
22321 W Morning Glory St, Buckeye, AZ, 85326-7181
Phone Number
503-209-7572
Fax Number
602-455-4624
Provider Enumeration Date
10/23/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
22321 W Morning Glory St
City
Buckeye
State
Arizona
Zip
85326-7181
Phone Number
503-209-7572
Fax Number
602-455-4624
person
Provider Business Mailing Address Details
Address
22321 W Morning Glory St
City
Buckeye
State
Arizona
Zip
85326-7181
Phone Number
503-209-7572
Fax Number
602-455-4624
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Foster Care Agency
Speciality
-
Taxonomy
253J00000X
License No.
3311474 (Arizona)
Definition
A Foster Care Agency is an agency that provides foster care as defined in the Code of Federal Regulations (CFR) as "24-hour substitute care for children outside their own homes." Foster care settings include, but are not limited to, nonrelative foster family homes, relative foster homes (whether payments are being made or not), group homes, emergency shelters, residential facilities, and pre-adoptive homes.
person
Provider's Taxonomy Details 2
Type
Respite Care Facility
Classification
Respite Care
Speciality
Respite Care, Mental Illness, Child
Taxonomy
385HR2055X
License No.
9911474 (Arizona)
Definition
A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental illness, as respite for the regular caregivers.
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