=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295697241
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | 10 INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/28/2025
-----------------------------------------------------
Last Update Date | 11/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 502 FOULKES DR
-----------------------------------------------------
City | TERRE HAUTE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47802-2438
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 447-301-4064
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 502 FOULKES DR
-----------------------------------------------------
City | TERRE HAUTE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47802-2438
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FOUNDER
-----------------------------------------------------
Name | TIAESHA LATASHA JACKSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 447-301-4064
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------