A & J Residential Services LLC
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Petersburg, VA. Organization (NPI-2).
NPI number1376188912
StatusActive
Last updated in NPPESNov 8, 2023
Details
- NPI
- 1376188912
- Entity type
- Organization (NPI-2)
- Legal business name
- A & J Residential Services LLC
- Organization subpart
- No
- Enumeration date
- Nov 7, 2019
- Certification date
- May 28, 2022
- Last updated
- Nov 8, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | – | Yes |
| 251C00000X | Day Training, Developmentally Disabled Services | – | – | |
| 251J00000X | Nursing Care | – | – | |
| 343900000X | Non-emergency Medical Transport (VAN) | – | – |
Practice location
2022 Country Lane CtPetersburg, VA 23805-2005
Phone 804-721-0707
Mailing address
2022 Country Lane CtPetersburg, VA 23805-2005
Phone 804-721-0707
Other practice locations
1817 Boydton Plank Rd
Petersburg, VA 23805-8919
Petersburg, VA 23805-8919
Phone 804-721-0707
Authorized official
Jennifer K Perez
Ceo/Nurse
8047210707
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