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Mr. Marcus S Jackson SR.
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Pensacola, Florida
NPI 1336767128

Marcus S Jackson SR. is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Pensacola, FL. Marcus S Jackson SR. practices in Pensacola, FL. The NPI Number for Marcus S Jackson SR. is 1336767128 and holds a License No. (Florida).

The current practice location address for Marcus S Jackson SR. is 5615 Shell Rd, Pensacola, FL and can be reached out via phone at 850-791-6604.

Location: 5615 Shell Rd, Pensacola, FL, 32503-7825
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1336767128
Provider Name
Marcus S Jackson SR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
5615 Shell Rd, Pensacola, FL, 32503-7825
Phone Number
850-791-6604
Fax Number
Provider Enumeration Date
07/08/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
5615 Shell Rd
City
Pensacola
State
Florida
Zip
32503-7825
Phone Number
850-791-6604
Fax Number
person
Provider Business Mailing Address Details
Address
5615 Shell Rd
City
Pensacola
State
Florida
Zip
32503-7825
Phone Number
850-791-6604
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
()
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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