IndividualActive
Jerome Jackson
NPI 1740815497 · Foster Care Agency · Peoria, AZ
Provider details
- NPI number
- 1740815497
- Entity type
- Individual
- Primary specialty
- Foster Care AgencyAgencies
- Sex
- Male
- Sole proprietor
- Yes
- License
- 10195508 (AZ)
Specialties & taxonomies
Agencies
Respite Care Facility
Profile Score
Established profile(64/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 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
9680 W Northern Ave Unit 2311
Peoria, AZ 85345-4655
Phone: (989) 980-8286
Fax: (602) 455-4626
Approximate (ZIP-level) locationGet directions
Mailing address
9680 W Northern Ave Unit 2311
Peoria, AZ 85345-4655
Registry dates
- Enumerated
- 2020-03-03
- Last updated
- 2020-03-03
- Certified
- 2020-03-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.