Individual
LARHONDA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
107 REDFORD DR, GROVETOWN, GA 30813-2212
(706) 814-1685
Mailing address
107 REDFORD DR, GROVETOWN, GA 30813-2212
(706) 814-1685
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
GA
385H00000X
Respite Care
—
GA
385HR2055X
Child Mental Illness Respite Care
—
GA
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
GA
385HR2065X
Child Physical Disabilities Respite Care
—
GA
Other
Enumeration date
10/10/2025
Last updated
10/24/2025
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