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Jackson Group Home
Intellectual Disabilities Intermediate Care Facility in Alexandria, Louisiana
NPI 1598784647

Jackson Group Home is a Intellectual Disabilities Intermediate Care Facility based in Alexandria, LA. Jackson Group Home practices in Alexandria, LA. The NPI Number for Jackson Group Home is 1598784647 and holds a License No. 814 (Louisiana).

The current practice location address for Jackson Group Home is 325 Mckeithen Drive, Alexandria, LA and can be reached out via phone at 318-473-0217 and via fax at 318-473-0256.

Location: 325 Mckeithen Drive, Alexandria, LA, 71306-0917
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1598784647
Provider Name
Jackson Group Home
Credential
Provider Entity Type
Organization
Address
325 Mckeithen Drive, Alexandria, LA, 71306-0917
Phone Number
318-473-0217
Fax Number
318-473-0256
Provider Enumeration Date
07/19/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1713686 01 LA UNISYS
institution
Provider Business Practice Location Address Details
Address
325 Mckeithen Drive
City
Alexandria
State
Louisiana
Zip
71303
Phone Number
318-473-0217
Fax Number
318-473-0256
person
Provider Business Mailing Address Details
Address
325 Mckeithen Drive
City
Alexandria
State
Louisiana
Zip
71303
Phone Number
318-473-0217
Fax Number
318-473-0256
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
814 (Louisiana)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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