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SHIRLEY MCMILLAN JACKSON
NPI 1063838878
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Mobile, AL

Active since March 17, 2014
2117 LUCKNER CT, MOBILE, AL 36618(251) 423-8197(251) 452-4797 Get Directions Write a Review

NPPES record last updated: March 17, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Shirley Mcmillan Jackson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHIRLEY MCMILLAN JACKSON (NPI 1063838878) is an individual community based residential treatment facility, intellectual and/or developmental disabilities provider in Mobile, Alabama and active in the NPI registry since March 2014.

NPPES Registry Identity

NPI1063838878
Entity TypeIndividualFemale
Primary Taxonomy320900000X
Provider Legal NameSHIRLEY MCMILLAN JACKSON
Location Address2117 LUCKNER CTMobile, AL 36618-2618
Mailing Address410 S Wilson AvePrichard, AL 36610-3910 · (251) 423-1897 · Fax (251) 452-4797
Phone(251) 423-8197
Fax(251) 452-4797
Sole ProprietorYes
Enumeration DateMarch 17, 2014
✔ NPI 1063838878 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320900000X
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
2117 LUCKNER CT, Mobile, AL 36618
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EXCLUSIVE RESIDENTIAL SERVICE LLC
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
2117 LUCKNER CT
MOBILE, AL 36618
Mobile County (251) 341-1764

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shirley Mcmillan Jackson's NPI number?

The NPI number for Shirley Mcmillan Jackson is 1063838878. It was assigned to this individual provider in the NPPES registry on March 17, 2014.

Where is Shirley Mcmillan Jackson located?

Shirley Mcmillan Jackson practices at 2117 Luckner Ct, Mobile, AL 36618. The listed phone number is (251) 423-8197.

What is Shirley Mcmillan Jackson's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

When was this NPI record last updated?

The NPPES record for Shirley Mcmillan Jackson was last updated on March 17, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.