MEDICARE: JACKSON & COMPANY HOLDINGS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1902609175
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JACKSON & COMPANY HOLDINGS LLC

Provider Business Mailing Address
First Line	:	1501 PINECREST RD
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27803-1834
Country	:	US
Telephone Number	:	919-559-4863
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 PINECREST RD
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27803-1834
Country	:	US
Telephone Number	:	919-559-4863
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DEANNA MARIE JACKSON
Credential	:
Telephone Number	:	919-559-4863

Provider Enumeration Date	:	03/31/2025
Last Update Date	:	03/31/2025

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Directions to “JACKSON & COMPANY HOLDINGS LLC ” Practice Location

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