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Search › Arizona › Intellectual and/or Developmental Disabilities Residential Treatment Facility

Willie Jackson

NPI 1144061649 · on the registry since 2024 · sole proprietor

Practice

Address
400 N Pima
Mesa, AZ 85201
Phone
(602) 551-0659

Registry record

Primary taxonomy
Intellectual and/or Developmental Disabilities Residential Treatment Facility
320600000X
Also registered as
Rehabilitation Clinic/Center
Behavior Technician
Licence states on file
AZ
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2026-01-30

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Arizona