Organization
JO FIRST RESIDENTIAL SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TILAYE KASSAHUN ABATE (CEO)
(804) 380-3504
Entity
Organization
Contact information
Practice address
10624 SARATA LN, CHESTERFIELD, VA 23832-7117
(804) 380-3504
(804) 380-3504
Mailing address
1701 QUAIL COVEY RD, HENRICO, VA 23238-3488
(804) 380-3504
(804) 380-3504
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
Other
Enumeration date
06/28/2024
Last updated
06/28/2024
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