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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. ANTWAIN JACKSON

Active

MR. ANTWAIN JACKSON is a Day Training/Habilitation healthcare provider located in DECATUR, Alabama. NPI 1063096147 is currently active in the NPPES registry. Verify at CMS.

Day Training/Habilitation · DECATUR, AL

Registration Details

NPI Number
1063096147
Provider Type
Individual
Gender
Male
NPI Issued
May 5, 2021 (5.2999235718386 yrs)
Last Updated
May 5, 2021

Practice Information

Address
1711 10TH AVE SE
DECATUR, AL, 356014915
Browse AL providers · Browse ZIP 35601
Phone
2562260150
Primary Specialty
Day Training/Habilitation
373H00000X
Additional Specialty
Day Training/Habilitation
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.