Organization
JAN'S RESIDENTIAL HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY BENNETT ADMINISTRATOR/CNA (ADMINISTRATOR)
(434) 430-0993
Entity
Organization
Contact information
Practice address
307 N HIGH ST, BLACKSTONE, VA 23824-1421
(434) 676-1372
(434) 676-1062
Mailing address
307 N HIGH ST, BLACKSTONE, VA 23824-1421
(434) 676-1372
(434) 676-1062
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
VA
320800000X
Mental Illness Community Based Residential Treatment Facility
—
VA
Other
Enumeration date
05/31/2015
Last updated
05/31/2015
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