Organization
A & J RESIDENTIAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER K PEREZ (CEO/NURSE)
(804) 721-0707
Entity
Organization
Contact information
Practice address
2022 COUNTRY LANE CT, PETERSBURG, VA 23805-2005
(804) 721-0707
Mailing address
2022 COUNTRY LANE CT, PETERSBURG, VA 23805-2005
(804) 721-0707
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251J00000X
Nursing Care Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3068
—
VA
Enumeration date
11/07/2019
Last updated
11/08/2023
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