Individual
RICHARD JACKSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
811 CRESTE DR, DECATUR, GA 30035-4135
(678) 881-7888
Mailing address
811 CRESTE DR, DECATUR, GA 30035-4135
(678) 881-7888
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
GA
Other
Enumeration date
09/23/2025
Last updated
10/24/2025
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