MR. ROBERT WALLACE JACKSON NPI 1932791993

NPI Information

  • NPI: 1932791993
  • Provider Name: MR. ROBERT WALLACE JACKSON
  • Classification: In Home Supportive Care - 253Z00000X
  • Entity Type: Individual
  • Address: 1355 TERRELL MILL RD SE BLDG 1462-125
    MARIETTA, GA
    ZIP 30067
  • Phone: (470) 632-7400

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NPI Details

MR. Robert Wallace Jackson is an in home supportive care in Marietta, GA. The provider is an In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. MR. Robert Wallace Jackson NPI is 1932791993. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1355 TERRELL MILL RD SE BLDG 1462-125
MARIETTA, GA
ZIP 30067-559
Phone: (470) 632-7400
Fax: (470) 524-0500

The enumeration date for this NPI number is 2/10/2021 and was last updated on 2/10/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1253Z00000XIn Home Supportive CarePHCP010932GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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