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JACKSON STYLE AGENCY, LLC
NPI 1386701613
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Grandview, MO

Active since January 03, 2007
213 BLUE RIDGE EXT, GRANDVIEW, MO 64030(816) 765-9990(816) 765-9987 Get Directions Write a Review

NPPES record last updated: July 10, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jackson Style Agency, Llc NPPES

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

JACKSON STYLE AGENCY, LLC (NPI 1386701613) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Grandview, Missouri and active in the NPI registry since January 2007. The organization lists Cleotha Jackson, Assistant Administrator, as its authorized official.

NPPES Registry Identity

NPI1386701613
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameJACKSON STYLE AGENCY, LLC
Location Address213 BLUE RIDGE EXTGrandview, MO 64030-1603
Mailing Address213 Blue Ridge ExtGrandview, MO 64030-1603 · (816) 765-9990 · Fax (816) 765-9987
Phone(816) 765-9990
Fax(816) 765-9987
Organization SubpartNo
Authorized OfficialCleotha JacksonAssistant Administrator · (816) 765-9990
Enumeration DateJanuary 3, 2007
Last NPPES UpdateJuly 10, 2007
✔ NPI 1386701613 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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.
Also ListedResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesTaxonomy 320600000X
213 BLUE RIDGE EXT, Grandview, MO 64030
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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 Jackson Style Agency, LLC's NPI number?

The NPI number for Jackson Style Agency, LLC is 1386701613. It was assigned to this organization in the NPPES registry on January 3, 2007.

Where is Jackson Style Agency, LLC located?

Jackson Style Agency, LLC is located at 213 Blue Ridge Ext, Grandview, MO 64030. The listed phone number is (816) 765-9990.

What is Jackson Style Agency, LLC'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 Jackson Style Agency, LLC was last updated on July 10, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.