Organization
G.R. JACKSON SENIOR CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ORTEASA MARIA TAFIE CNA (OWNER)
(404) 274-4498
Entity
Organization
Contact information
Practice address
1325 SIX FLAGS DR, #1207, AUSTELL, GA 30168-7065
(404) 274-4498
(678) 324-6791
Mailing address
1325 SIX FLAGS DR, #1207, AUSTELL, GA 30168-7065
(404) 274-4498
(678) 324-6791
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
CN0028902879
GA
Other
Enumeration date
04/19/2011
Last updated
04/19/2011
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