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General NPI Number Information
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NPI Number | 1386828648
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Entity Type | Organization
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Legal Business Name | FELECIA I. JACKSON/MEJA HEALTH CARE SERVICES
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Dates
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Enumeration Date | 12/21/2007
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Last Update Date | 03/21/2010
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Provider Practice Location Address
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Address Line | 5115 MANORHAVEN LN
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City | HOUSTON
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State | TX
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Zip | 77084-2392
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Country | US
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Telephone | 281-463-9909
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Fax | 281-463-9909
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Provider Business Mailing Address
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Address Line | 22136 WESTHEIMER PARKWAY SUITE 344
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City | KATY
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State | TX
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Zip | 77450-8296
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Country | US
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Telephone | 281-463-9909
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Fax | 281-463-9909
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Authorized Official
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Title or Position | DIRECT OWNER/ADMINISTRATOR
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Name | MS. FELECIA IRIS JACKSON
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Credential | R.N.
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Telephone | 281-463-9909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 683656 (R.N.)
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 11608429
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License Number State | TX
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