| Jackson Behavioral Health Services Llc | |
|
4137 Sauk Trl Ste 146 Richton Park IL 60471-1253 | |
| (708) 983-8074 | |
| Not Available |
| Full Name | Jackson Behavioral Health Services Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4137 Sauk Trl Ste 146, Richton Park, Illinois |
| Authorized Official Name and Position | Addison Jackson (DIRECTOR) |
| Authorized Official Contact | 7089838074 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Behavioral Health Services Llc 4137 Sauk Trl Ste 146 Richton Park IL 60471-1253 Ph: () - | Jackson Behavioral Health Services Llc 4137 Sauk Trl Ste 146 Richton Park IL 60471-1253 Ph: (708) 983-8074 |
| NPI Number | 1063046498 |
|---|---|
| Provider Enumeration Date | 02/25/2020 |
| Last Update Date | 02/25/2020 |
| Certification Date | 02/25/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063046498 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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