OrganizationActive
Jackson Group Home LLC
NPI 1487890786 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Hannibal, MO
Provider details
- NPI number
- 1487890786
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Lora Culp, Owner/Operator(573) 221-4671
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Residential Treatment Facilities
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
18 Ridgewood Dr
Hannibal, MO 63401-3056
Phone: (573) 221-4671
Fax: (573) 221-4671
Street-level locationGet directions
Mailing address
18 Ridgewood Dr
Hannibal, MO 63401-3056
Registry dates
- Enumerated
- 2008-12-17
- Last updated
- 2017-04-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.