MELVIN JACKSON (NPI# 1831336411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831336411 |
| Entity Type | Individual |
| Full Name | MELVIN JACKSON |
| Practice Address |
2415 N 124th Cir Avondale AZ 85392-6509 |
| Practice Telephone | 6028413438 |
| Mailing Telephone | 6028413438 |
| Enumeration Date | 2009-01-19 |
| Last Update Date | 2009-01-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 11297 | AZ | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578924551 | Melvin Jackson | Counselor | 1018 Campbell Ave, Ville Platte, LA 70586-8555 | 2016-03-17 |
| 1588657217 | Melvin E. Jackson | Optometrist | 4642 Haygood Rd, Suite 1, Virginia Beach, VA 23455-5436 | 2005-08-29 |
| 1508172214 | Melvin Jackson IIi | Pharmacist | 410 Creswell Ln, Opelousas, LA 70570-5810 | 2010-08-19 |
| 1710137567 | Melvin Jackson | Case Manager/Care Coordinator | 2707 Browns Ln, Jonesboro, AR 72401-7213 | 2008-09-29 |
| 1730281676 | Melvin Allen Jackson Sr. | Social Worker | 1492 W Flagler St, Miami, FL 33135-2209 | 2006-09-01 |
| 1962511535 | Melvin Jackson | Family Medicine | 777 Hemlock St, Hb 64, Macon, GA 31201-2102 | 2006-08-29 |
| 1922049295 | Melvin L Jackson | Emergency Medicine | 1225 Wilshire Boulevard, Good Samaritan Hospital, Los Angeles, CA 90017-2395 | 2006-06-09 |
| Street Address |
2415 N 124TH CIR |
| City | AVONDALE |
| State | AZ |
| Zip Code | 85392-6509 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639247463 | Linda Graham | Respite Care | 2415 N 124th Cir, Avondale, AZ 85323-6509 | 2006-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972100063 | Arizona Imaging Center, LLC | Radiology | 10825 W Mcdowell Rd Suite 130, Avondale, AZ 85392 | 2020-10-02 |
| 1376159053 | Quick Med Center LLC | Clinic/Center | 10825 W Mcdowell Rd Suite 100, Avondale, AZ 85392 | 2020-09-18 |
| 1225641046 | Ambulatory Surgery Centers, LLC | Clinic/Center | 10825 W Mcdowell Rd Suite 110, Avondale, AZ 85392 | 2020-08-31 |
| 1144842394 | National Cardiovascular Surgery Center, LLC | Clinic/Center | 10825 W Mcdowell Rd, Suite 310, Avondale, AZ 85392 | 2020-05-11 |
| 1073077145 | Lakeview Dentistry P.C., Inc. | Dentist | 10750 W. Mcdowell Road, Bldg. D410, Avondale, AZ 85392 | 2019-01-23 |
| 1699249458 | Elaine Van De Wille | Student in an Organized Health Care Education/Training Program | 3609 N 109th Ave, Avondale, AZ 85392 | 2019-01-15 |
| 1750890075 | West Valley Pediatrics | Nurse Practitioner | 10750 West Mcdowell Rd, Suite G700, Avondale, AZ 85392 | 2017-09-29 |
| 1336675305 | Hope-ann Kamler | Licensed Practical Nurse | 2150 North Santa Fe Blvd, Avondale, AZ 85392 | 2017-05-11 |
| 1790237527 | Visionworks, Inc | Eyewear Supplier (Equipment, not the service) | 10285 West Mcdowell Rd, Ste A-102, Avondale, AZ 85392 | 2016-10-27 |
| 1063969137 | Lorri Ward | Registered Nurse | 12750 W Coronado Rd, Avondale, AZ 85392 | 2016-09-07 |
| Find all providers in zip 85392 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871113563 | New Hope of Arizona, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 12545 W Woodland Ave, Avondale, AZ 85323-8025 | 2020-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528666039 | Rehoboth LLC | Residential Treatment Facility, Emotionally Disturbed Children | 46136 W Mountain View Rd # A, Maricopa, AZ 85139-6796 | 2020-10-16 |
| 1962022665 | New Hope of Arizona, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 8710 W Watkins St, Tolleson, AZ 85353-9028 | 2020-04-22 |
| 1639798143 | Anthony Udoinwang | Residential Treatment Facility, Emotionally Disturbed Children | 10435 W Reade Ave, Glendale, AZ 85307-4237 | 2020-04-14 |
| 1033756358 | Native Music Coalition | Residential Treatment Facility, Emotionally Disturbed Children | 5150 S Crazy Cat Ln, Tucson, AZ 85735 | 2019-12-05 |
| 1013558311 | Back To Life Incorporated | Residential Treatment Facility, Emotionally Disturbed Children | 6420 W Cocopah St, Phoenix, AZ 85043 | 2019-10-08 |
| 1487118865 | Serenity Preferred LLC | Residential Treatment Facility, Emotionally Disturbed Children | 17829 W Columbine Dr, Surprise, AZ 85388-5628 | 2019-01-30 |
| 1407333958 | Copa's Caring Hands LLC. | Residential Treatment Facility, Emotionally Disturbed Children | 42251 W Bravo Dr, Maricopa, AZ 85138-2295 | 2018-07-26 |
| 1538668983 | Starks Homes LLC | Residential Treatment Facility, Emotionally Disturbed Children | 7325 E Fayette St, Tucson, AZ 85730-2324 | 2018-02-12 |
| 1881100147 | Anna Marie Barrios | Residential Treatment Facility, Emotionally Disturbed Children | 18811 N 7th Dr, Phoenix, AZ 85027-5508 | 2017-12-22 |
| 1033625926 | Youth Transition Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1190 S Boulder St Unit D, Gilbert, AZ 85296-3792 | 2017-12-14 |
| 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.