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General NPI Number Information
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NPI Number | 1174418198
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Entity Type | Organization
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Legal Business Name | JACKSON PREFERRED CARE LLC
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Dates
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Enumeration Date | 06/10/2025
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 10711 SW 216TH ST # 201
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City | MIAMI
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State | FL
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Zip | 33170-3139
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Country | US
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Telephone | 786-227-6543
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Fax | 305-939-0826
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Provider Business Mailing Address
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Address Line | 17516 DUVAL AVE
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City | MIAMI
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State | FL
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Zip | 33157-5322
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Country | US
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Telephone | 786-531-1923
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Fax | 786-531-1923
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Authorized Official
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Title or Position | HOME AND COMMUNITY BASED PROVIDER
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Name | CASHAE T MORTON
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Credential |
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Telephone | 786-227-6543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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