Organization
JACKSON FEILD HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT E CRANE (CHIEF FINANCIAL OFFICER)
(434) 634-3217
Entity
Organization
Contact information
Practice address
546 WALNUT GROVE DR, JARRATT, VA 23867-8611
(434) 634-3217
(434) 348-3417
Mailing address
546 WALNUT GROVE DR, JARRATT, VA 23867-8611
(434) 634-3217
(434) 348-3417
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
278-05
VA
323P00000X
Psychiatric Residential Treatment Facility
Primary
1376
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578720397
—
VA
Enumeration date
05/20/2008
Last updated
01/17/2013
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