CHRISTOPHER ROBERT JACKSON


Address: 1502 Liatris Ln, North Pole, AK 99705-5082
Phone: 9073855733

CHRISTOPHER ROBERT JACKSON (NPI# 1417502998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1417502998
Entity Type Individual
Full Name CHRISTOPHER ROBERT JACKSON
Practice Address 1502 Liatris Ln
North Pole
AK 99705-5082
Mailing Address 1680 Midland St
North Pole
AK 99705-5881
Practice Telephone 9073855733
Mailing Telephone 9073855733
Enumeration Date 2019-08-01
Last Update Date 2019-08-01
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 322D00000X Residential Treatment Facility, Emotionally Disturbed Children 523381 AK Residential Treatment Facilities

Other Providers CHRISTOPHER JACKSON

NPI Name Taxonomy Address Enumeration
1144880469 Christopher Luke Jackson Registered Nurse 2177 N Brower St, Simi Valley, CA 93065-2447 2019-06-18
1427612480 Christopher John Jackson Registered Nurse 8921 Harvey St, Livonia, MI 48150-3518 2019-04-25
1972009041 Christopher Carl Jackson Physical Therapist 1230 Felice Cutoff Rd, Ragley, LA 70657-6645 2018-04-05
1538674312 Christopher D. Jackson Counselor 165 Warner St, Rochester, NY 14606-1832 2017-12-03
1720513997 Christopher Ainsley Nally Jackson Massage Therapist 124 Wren Way, Newark, DE 19711-8330 2017-04-25
1073980736 Christopher G Jackson Physical Therapist 3143 Pelham Pkwy Ste 400, Pelham, AL 35124-6301 2015-08-28
1932442498 Christopher Paul Jackson Technician 7821 Island Dr, Anchorage, AK 99504-2728 2013-04-03
1710229224 Christopher Mitchell Jackson Neurological Surgery 600 N Wolfe St Tower 110, The Johns Hopkins Hospital, Baltimore, MD 21287-2109 2013-03-22
1417107947 Christopher L Jackson Acupuncturist 7901 4th St N Ste 312, St Petersburg, FL 33702 2008-09-20
1841446416 Christopher Paul Jackson Physical Therapist 1051 W Us Rt 6, Suite 400, Morris, IL 60450 2008-08-14

Office Location

Street Address 1502 LIATRIS LN
City NORTH POLE
State AK
Zip Code 99705-5082

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1225508815 Madison Grove Behavioral Analyst 203 S. Santa Claus Lane, North Pole, AK 99705 2018-11-27
1104393123 Jessica Marie Childress Behavioral Analyst 203 Santa Clause, North Pole, AK 99705 2018-10-29
1346722279 Kimberly Shriner Student in an Organized Health Care Education/Training Program 1970 Hollowell Rd, North Pole, AK 99705 2018-09-06
1780108993 Tracy Norris Behavior Technician 1000 Borda St., North Pole, AK 99705 2017-07-29
1912134420 Donald Jermome Kosatka Psychiatry & Neurology Building 4066 602nd Street, Bassett Army Community Hospital, Fort Wainwright, AK 99705 2009-06-11
1174796247 Monique Dase Smith Psychiatry & Neurology 1650 Cowles St., Fairbanks, AK 99705 2008-04-09
1376742494 Vicki Elaine Readnour Physical Therapist 167-b Santa Claus Lane, North Pole, AK 99705 2007-07-18
1114091527 Helyn M Lefgren Family Medicine 145 Santa Claus Lane, North Pole, AK 99705 2006-11-17
1174695803 Eric P Buetow Dentist 2933 Horseshoe Way, North Pole, AK 99705 2006-11-15
1770578296 North Pole Prescription Laboratory Inc Pharmacy 167 Santa Claus Lane, North Pole, AK 99705 2005-09-12
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Taxonomy Information

Taxonomy Code 322D00000X
Grouping Residential Treatment Facilities
Classification Residential Treatment Facility, Emotionally Disturbed Children

Taxonomy Definition

A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment.
Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1982228177 Juneau Youth Services, Inc. Residential Treatment Facility, Emotionally Disturbed Children 8460 Rainbow Row, Juneau, AK 99801-9041 2020-06-03
1447874631 Juneau Youth Services, Inc. Residential Treatment Facility, Emotionally Disturbed Children 10815 Black Bear Rd, Juneau, AK 99801-8783 2020-06-03
1043834245 Juneau Youth Services, Inc. Residential Treatment Facility, Emotionally Disturbed Children 10685 Mendenhall Loop Rd, Juneau, AK 99801 2020-06-03
1295359511 Juneau Youth Services, Inc. Residential Treatment Facility, Emotionally Disturbed Children 10801 Black Bear Rd, Juneau, AK 99801 2020-06-02
1700400033 Juneau Youth Services, Inc. Residential Treatment Facility, Emotionally Disturbed Children 10685 Mendenhall Lp Rd, Juneau, AK 99801 2020-06-02
1326396821 Presbyterian Hospitality House Residential Treatment Facility, Emotionally Disturbed Children 2771 E Hiawatha Dr, Wasilla, AK 99654-2853 2012-08-15
1598013096 Presbyterian Hospitality House Residential Treatment Facility, Emotionally Disturbed Children 1145 W Granville St, Palmer, AK 99645-7118 2012-08-15
1639425812 Presbyterian Hospitality House Residential Treatment Facility, Emotionally Disturbed Children 6969 S Hood Ct, Wasilla, AK 99624 2012-07-25
1457528366 Boys and Girls Home of Alaska Residential Treatment Facility, Emotionally Disturbed Children 3101 Lathrop Street, Fairbanks, AK 99707-0870 2008-05-09
1073701033 Alaska Family Services Inc. Residential Treatment Facility, Emotionally Disturbed Children 1825 S Chugach Street, Palmer, AK 99645 2007-10-04
Find all providers with the same taxonomy

Competitor

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City NORTH POLE
Zip Code 99705

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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