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Jackson Home, Inc.

Emotionally Disturbed Childrens' Residential Treatment Facility in Fairmont, NC · enumerated 2007 · authorized official Glenda Jackson, Director.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1285838805

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Registry record

Entity type Organization (Type 2)
Legal business name Jackson Home, Inc.
Practice address 509 Holly St, Fairmont, NC, 28340
Phone (910) 628-7171
Enumeration date Jun 14, 2007
Last updated in NPPES Aug 22, 2020

Taxonomy & classification

322D00000X Emotionally Disturbed Childrens' Residential Treatment Facility Residential Treatment Facilities · License MHL078158 (NC) Primary

Authorized official

Name Glenda Jackson
Title Director
Phone (910) 628-7171

Other identifiers

Identifier Type State Issuer
6603889 Medicaid NC -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What type of organization is Jackson Home, Inc.?
Jackson Home, Inc. is registered in NPPES as a Emotionally Disturbed Childrens' Residential Treatment Facility (its primary provider taxonomy).
What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-08-22.