Organization
JAKES PLACE GROUP HOME LLC
Active
Organization
JAKES PLACE GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TINA MARIE EVANS (CHIEF EXECUTIVE OFFICER)
(757) 641-4832
Entity
Organization
Contact information
Practice address
33023 HARVEST DR, CARRSVILLE, VA 23315-2123
(757) 641-4832
Mailing address
33023 HARVEST DR, CARRSVILLE, VA 23315-2123
(757) 641-4832
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
08/14/2026
Last updated
08/14/2026
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