JACKSON HOUSE
NPI 1457873317
Community Based Residential Treatment Facility, Mental Illness in La Mesa, CA
About Jackson House NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACKSON HOUSE (NPI 1457873317) is a healthcare organization registered as a community based residential treatment facility, mental illness in La Mesa, California and active in the NPI registry since July 2017. The organization holds a CLIA Waiver certificate valid through January 7, 2027 and lists Chad Engbrecht, Chief Financial Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 05D2316569
Bh-Sd Social Rehab Lm, LLC Dba Jackson House · La Mesa, CAOther Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LA MESA, CA 91942
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 Bh-Sd Social Rehab Lm, LLC's NPI number?
The NPI number for Bh-Sd Social Rehab Lm, LLC is 1457873317. It was assigned to this organization in the NPPES registry on July 12, 2017. The provider is doing business as Jackson House.
Where is Bh-Sd Social Rehab Lm, LLC located?
Bh-Sd Social Rehab Lm, LLC is located at 5332 Jackson Dr, La Mesa, CA 91942. The listed phone number is (619) 667-6009.
What is Bh-Sd Social Rehab Lm, LLC's specialty?
The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.
Does Bh-Sd Social Rehab Lm, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 05D2316569) is associated with this NPI, valid through January 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Bh-Sd Social Rehab Lm, LLC was last updated on January 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Jackson House · NPI 1457873317
Community Based Residential Treatment Facility, Mental Illness organization in La Mesa, California. Organization record, active in the CMS NPPES registry since July 12, 2017.
## Identity
- **NPI:** 1457873317 (Entity type: Organization)
- **Enumerated:** July 12, 2017
- **Primary specialty:** Community Based Residential Treatment Facility, Mental Illness · taxonomy 320800000X
- **Legal business name:** Bh-Sd Social Rehab Lm, Llc
- **Organization subpart:** No
- **Authorized official:** Chad Engbrecht, CHIEF FINANCIAL OFFICER
## Practice location
- **Address:** 5332 JACKSON DR, La Mesa, CA 91942-3040
- **Phone:** (619) 667-6009 · **Fax:** (619) 667-6118
## Record status
- **NPPES last updated:** January 11, 2024
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1457873317) · Data from the CMS NPPES public registry.