Provider Demographics
NPI:1174418198
Name:JACKSON PREFERRED CARE LLC
Entity type:Organization
Organization Name:JACKSON PREFERRED CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOME AND COMMUNITY BASED PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:CASHAE
Authorized Official - Middle Name:T
Authorized Official - Last Name:MORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-227-6543
Mailing Address - Street 1:17516 DUVAL AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-5322
Mailing Address - Country:US
Mailing Address - Phone:786-531-1923
Mailing Address - Fax:786-531-1923
Practice Address - Street 1:10711 SW 216TH ST # 201
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170-3139
Practice Address - Country:US
Practice Address - Phone:786-227-6543
Practice Address - Fax:305-939-0826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child