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Search › North Carolina › Mental Illness Community Based Residential Treatment Facility

Jalisa Jackson

NPI 1366041667 · on the registry since 2020 · sole proprietor

Practice

Address
11413 Mangla Dr
Charlotte, NC 28214
Phone
(704) 819-4909
Organisation at this address
Urbanized Llc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
Mental Illness Community Based Residential Treatment Facility
320800000X
Licence states on file
NC
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2020-10-19

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 North Carolina