JACKSON HOME FOR VETERANS (NPI# 1467051631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467051631 |
| Entity Type | Organization |
| Organization Name | JACKSON HOME FOR VETERANS |
| Practice Address |
2633 Juniper Dr Charlotte NC 28269-4004 |
| Practice Telephone | 7043157089 |
| Mailing Telephone | 7043157089 |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2020-10-23 |
| Authorized Official Name | LEVAR LAFAYETTE JACKSON (OWNER) |
| Authorized Official Telephone | 7043157089 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 302R00000X | Health Maintenance Organization | Managed Care Organizations | ||
| N | 261QM1000X |
Clinic/Center Specialization: Migrant Health |
Ambulatory Health Care Facilities | ||
| Y | 177F00000X | Lodging | Other Service Providers |
| Street Address |
2633 JUNIPER DR |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28269-4004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124664438 | Alluring Occupational Therapy Services, Pllc | Occupational Therapy Assistant | 3020-i Prosperity Church Rd, Ste 523, Charlotte, NC 28269 | 2019-11-21 |
| 1366085094 | Crystal R Currie | Counselor | 8824 Cliff Cameron Drive, Uint 107, Charlotte, NC 28269 | 2019-10-25 |
| 1477102879 | Apryl N. Davis | Occupational Therapy Assistant | 3020-i Prosperity Church Rd., Charlotte, NC 28269 | 2019-09-09 |
| 1730744202 | Christopher Paige | Driver | 9805 Statesville Rd., Suite 6198, Charlotte, NC 28269 | 2019-05-09 |
| 1619532892 | Krb Support Services | Prevention Professional | 11634 Oak Street, Charlotte, NC 28269 | 2019-05-03 |
| 1184186769 | Kimberly M Lynch | Local Education Agency (LEA) | 11634 Oat Street, Charlotte, NC 28269 | 2019-04-03 |
| 1356802318 | Arleen M Blythe | Physical Therapy Assistant | 1521 Bucklebury Ct, Charlotte, NC 28269 | 2019-03-30 |
| 1174089064 | Quality Behavioral Health Services, Pllc | Social Worker | 9805 Statesville Rd, # 6095, Charlotte, NC 28269 | 2019-02-15 |
| 1326517855 | Mary Frances Pickens-wilson | Behavior Technician | 4628 Quinton Lane, Charlotte, NC 28269 | 2018-11-14 |
| 1548746605 | Tiffany Michelle Graham | Counselor | 9823 Cooper Run Ln, Charlotte, NC 28269 | 2018-07-12 |
| Find all providers in zip 28269 | ||||
| Taxonomy Code | 177F00000X |
| Grouping | Other Service Providers |
| Classification | Lodging |
| A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184260002 | Carolina Premier Care Group LLC | Lodging | 3517 Cross Winds Rd, Charlotte, NC 28227-8638 | 2019-11-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831701903 | Another Chance: House of Refuge | Lodging | 1708 Chambers Dr Apt 15, Matthews, NC 28105-4782 | 2020-08-20 |
| 1003107277 | The Manor At Riverbrooke | Lodging | 3120 Tuckland Drive, Raleigh, NC 27610-5257 | 2011-04-22 |
| 1306161013 | Guiding Star Health Care Adult Group Home | Lodging | 2809 Huntington Ct, Rocky Mount, NC 27803-1641 | 2010-04-06 |
| 1285866319 | The Manor At Edgewater | Lodging | 1038 Stormy Ln, Raleigh, NC 27610-6074 | 2009-08-24 |
| 1528204286 | Kirk Matthew Ledoux | Lodging | 305 Causby Ln, Hendersonville, NC 28791-8721 | 2008-12-31 |
| 1114191921 | Carillon Assisted Living of Lincolnton, LLC | Lodging | 440 Salem Church Road, Lincolnton, NC 28092-8856 | 2008-04-14 |
| 1790966554 | The Manor At Coventry Creek | Lodging | 5124 Werribee Dr, Raleigh, NC 27616-5546 | 2007-11-21 |
| 1801081310 | Lee's Family Care Home | Lodging | 945 Vaiden Road, Louisburg, NC 27549-8096 | 2007-09-07 |
| 1467650036 | Pittman Family Care | Lodging | 47 Piney Haven Dr, Bakersville, NC 28705-0525 | 2007-07-05 |
| 1235334194 | Suzan Lynne Booker | Lodging | 1424 Huntdell Main Dr, Wendell, NC 27591-7254 | 2007-06-19 |
| Find all providers with the same taxonomy | ||||
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| 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.