Provider Demographics
NPI:1245929421
Name:JACKSON'S FACILITIES, INCORPORATED
Entity type:Organization
Organization Name:JACKSON'S FACILITIES, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-565-1468
Mailing Address - Street 1:1440 HOOD RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-2311
Mailing Address - Country:US
Mailing Address - Phone:916-565-1468
Mailing Address - Fax:916-900-4454
Practice Address - Street 1:1440 HOOD RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-2311
Practice Address - Country:US
Practice Address - Phone:916-565-1468
Practice Address - Fax:916-900-4454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home