JACKSON HOME HEALTH (NPI# 1578948055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578948055 |
| Entity Type | Organization |
| Organization Name | JACKSON HOME HEALTH |
| Practice Address |
111 Pecan Lake Estate Rd Monroe LA 71203-9383 |
| Practice Telephone | 3187894272 |
| Mailing Telephone | 3187894272 |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2015-09-12 |
| Authorized Official Name | SHONTIA LATOYIA GRAY (OWNER/MANAGER) |
| Authorized Official Telephone | 3187894272 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320700000X | Residential Treatment Facility, Physical Disabilities | LA | Residential Treatment Facilities |
| Street Address |
111 PECAN LAKE ESTATE RD |
| City | MONROE |
| State | LA |
| Zip Code | 71203-9383 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861840910 | S&r Non Emergency Medical Transportation | Non-emergency Medical Transport (VAN) | 111 Pecan Lake Estate Rd, Monroe, LA 71203-9383 | 2016-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801408083 | Bwilling Counseling, LLC | Counselor | 1500 North 19th Street, Monroe, La 71201, LA 71203 | 2020-08-19 |
| 1427683234 | Alexander Lee Forehan | Specialist/Technologist | 4099 Northeast Dr, Monroe, LA 71203 | 2020-03-12 |
| 1568923092 | Northeast Louisiana Veteran's Home | Department of Veterans Affairs (VA) Pharmacy | 6700 Highway 165n, Monroe, LA 71203 | 2019-03-27 |
| 1144708520 | Cassie Lord | Pharmacist | Brookshires, 7920 Desiard Street, Monroe, LA 71203 | 2018-07-30 |
| 1982196465 | Emmanuel D Hardy | Case Manager/Care Coordinator | 645 Hwy 80 East, Monroe, LA 71203 | 2018-05-31 |
| 1831689652 | Shereka Ruenet Devall | Counselor | 202 Lincoln Rd, Monroe, LA 71203 | 2018-05-17 |
| 1356830541 | David Whitney Bass | Counselor | 622 Riverside Drive, Monroe, La. 71203, Monroe, LA 71203 | 2018-05-03 |
| 1851821912 | Niatra S Bell | Counselor | 645 Highway 80 East, Monroe, LA 71203 | 2017-06-12 |
| 1528597523 | Amazing Transport, LLC | Non-emergency Medical Transport (VAN) | 6300 Mosswood Dr., Monroe, LA 71203 | 2017-06-05 |
| 1326581737 | Charla Gix | Case Manager/Care Coordinator | 645 Us-80, Monroe, LA 71203 | 2016-12-02 |
| Find all providers in zip 71203 | ||||
| Taxonomy Code | 320700000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Physical Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922299908 | Kestlerresthome | Residential Treatment Facility, Physical Disabilities | #5 N State Home Road, Monroe, NJ 08831 | 2007-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154615086 | Brenda Joan Brannon | Residential Treatment Facility, Physical Disabilities | 116 Dogwood Dr, Winnfield, LA 71483-5000 | 2011-06-08 |
| 1447497425 | Heavenly Medical Supply | Residential Treatment Facility, Physical Disabilities | 6349 Estates Dr, Bastrop, LA 71220-9749 | 2009-01-13 |
| 1225289382 | Loving Hands Assisted Living | Residential Treatment Facility, Physical Disabilities | 203 Nottingham Ln, Slidell, LA 70461-3311 | 2008-10-08 |
| 1063600369 | Frances Special Services, Inc | Residential Treatment Facility, Physical Disabilities | 418 E Magnolia St, Amite, LA 70422-3106 | 2007-10-11 |
| 1255535530 | Hannie Rehab L.l.c | Residential Treatment Facility, Physical Disabilities | 203 Rue Fountaine, Lafayette, LA 70508-5775 | 2007-06-12 |
| 1740713700 | Helping The Sick N Shut In of Noth La | Residential Treatment Facility, Physical Disabilities | 5342 Broadway Ave, Shreveport, LA 71109-7210 | 2017-04-06 |
| 1326235565 | Shekinah Glory | Residential Treatment Facility, Physical Disabilities | 3613 Government St, Baton Rouge, LA 70806-5721 | 2007-10-02 |
| 1013107689 | Partners for Health Community Services, Inc | Residential Treatment Facility, Physical Disabilities | 6547 N Foster Dr, Baton Rouge, LA 70811-6115 | 2007-07-30 |
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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.