Jackson, Ladonna

Jackson, Ladonna is an sole proprietor health care provider with primary practice located at 1866 N Marble Ridge Pl , Tucson AZ 85715-4574. She recently has 2 registered licenses in different health care specialties including Respite Care Facility / Respite Care, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness. Respite Care Facility / Respite Care is her primary health care specialty. Jackson, Ladonna can be contacted via phone (520) 722-9296.

Contact Information

Primary practice address
1866 N Marble Ridge Pl Tucson AZ 85715-4574
Phone: (520) 722-9296
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respite Care Facility / Respite Care 385H00000X BH4932 Arizona
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X BH-2808 Arizona

Profile Details

NPI number 1518032945
LBN Legal business name Jackson, Ladonna
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 21st, 2006
Last updated Jul 27th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518032945 NPPES
Arizona Other BH4932 AZ DEPT OF HEALTH SERVICES
Arizona MEDICAID 764721 AZ DEPT OF HEALTH SERVICES

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