Healthcare Provider Details

I. General information

NPI: 1831073428
Provider Name (Legal Business Name): DODSONS RESIDENTIAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11907 KEN DR
CHESTER VA
23831-1630
US

IV. Provider business mailing address

11907 KEN DR
CHESTER VA
23831-1630
US

V. Phone/Fax

Practice location:
  • Phone: 804-898-5322
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY DODSON
Title or Position: OWNER
Credential:
Phone: 804-898-5322