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Jackson Home, Inc.
Emotionally Disturbed Childrens' Residential Treatment Facility in Fairmont, North Carolina
NPI 1285838805

Jackson Home, Inc. is a Emotionally Disturbed Childrens' Residential Treatment Facility based in Fairmont, NC. Jackson Home, Inc. practices in Fairmont, NC. The NPI Number for Jackson Home, Inc. is 1285838805 and holds a License No. MHL078158 (North Carolina).

The current practice location address for Jackson Home, Inc. is 509 Holly St, Fairmont, NC and can be reached out via phone at 910-628-7171.

Location: 509 Holly St, Fairmont, NC, 28340-1705
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1285838805
Provider Name
Jackson Home, Inc.
Credential
Provider Entity Type
Organization
Address
509 Holly St, Fairmont, NC, 28340-1705
Phone Number
910-628-7171
Fax Number
Provider Enumeration Date
06/14/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
6603889 05 NC
institution
Provider Business Practice Location Address Details
Address
509 Holly St
City
Fairmont
State
North Carolina
Zip
28340-1705
Phone Number
910-628-7171
Fax Number
person
Provider Business Mailing Address Details
Address
509 Holly St
City
Fairmont
State
North Carolina
Zip
28340-1705
Phone Number
910-628-7171
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Emotionally Disturbed Children
Speciality
-
Taxonomy
322D00000X
License No.
MHL078158 (North Carolina)
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
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