CHRISTOPHER ROBERT JACKSON
NPI 1417502998
Residential Treatment Facility, Emotionally Disturbed Children in North Pole, AK
- Individual
- Male
- Residential Treatment Facility, Emotiona...
About CHRISTOPHER JACKSON
This page provides the complete NPI Profile along with additional information for Christopher Jackson, a provider established in North Pole, Alaska with a medical specialization in Residential Treatment Facility, Emotionally Disturbed Children. The healthcare provider is registered in the NPI registry with number 1417502998 assigned on August 2019. The practitioner's primary taxonomy code is 322D00000X with license number 523381 (AK). The provider is registered as an individual and his NPI record was last updated 7 years ago.
- NPI
- 1417502998 Verify this NPI
- Provider Name
- CHRISTOPHER ROBERT JACKSON
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1502 LIATRIS LN NORTH POLE, AK 99705
- Location Phone
- (907) 385-5733
- Mailing Address
- 1680 MIDLAND ST NORTH POLE, AK 99705
- Mailing Phone
- (907) 385-5733
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 08-01-2019
- Last Update Date
- 08-01-2019
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Residential Treatment Facility, Emotionally Disturbed Children
- Taxonomy Code
- 322D00000X
- Type
- Residential Treatment Facilities
- License No.
- 523381
- License State
- AK
- Taxonomy Description
- A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
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Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
NORTH POLE, AK 99705
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1417502998, enumerated as an "individual" on August 01, 2019.
The provider is located at 1502 LIATRIS LN NORTH POLE, AK 99705 and the phone number is (907) 385-5733.
Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.
