| Jackson Street Group Home | |
|
141 E Jackson St Coats NC 27521-8308 | |
| (919) 894-5124 | |
| (919) 894-1488 |
| Full Name | Jackson Street Group Home |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
| Location | 141 E Jackson St, Coats, North Carolina |
| Authorized Official Name and Position | Jennifer D Lozano (DIRECTOR OF REVENUE CYCLE) |
| Authorized Official Contact | 4043642900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Street Group Home 1819 Peachtree Rd Ne Ste 450 Atlanta GA 30309-1848 Ph: (404) 364-2900 | Jackson Street Group Home 141 E Jackson St Coats NC 27521-8308 Ph: (919) 894-5124 |
| NPI Number | 1750416228 |
|---|---|
| Provider Enumeration Date | 02/23/2007 |
| Last Update Date | 09/24/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750416228 | NPI | - | NPPES |
| 7802843 | Medicaid | NC |
Johari Family Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 27 East Main Street, Coats, NC 27521 Phone: 910-897-3000 | |
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