# G.R. JACKSON SENIOR CARE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467742858
- **Authorized official:** MRS. ORTEASA MARIA TAFIE CNA (OWNER)
- **Authorized official phone:** (404) 274-4498

## Contact information

- **Practice address:** 1325 SIX FLAGS DR, \#1207, AUSTELL, GA 30168-7065
- **Practice address phone:** (404) 274-4498
- **Practice address fax:** (678) 324-6791
- **Mailing address:** 1325 SIX FLAGS DR, \#1207, AUSTELL, GA 30168-7065
- **Mailing address phone:** (404) 274-4498
- **Mailing address fax:** (678) 324-6791

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | CN0028902879 | GA | Yes |

## Other

- **Enumeration date:** 04/19/2011
- **Last updated:** 04/19/2011