Healthcare Provider Details

I. General information

NPI: 1104742139
Provider Name (Legal Business Name): JZC COMMUNITY HOMES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14107 HAVERIDGE DR
MIDLOTHIAN VA
23112-1558
US

IV. Provider business mailing address

14321 WINTER BREEZE DR STE 45
MIDLOTHIAN VA
23113-2452
US

V. Phone/Fax

Practice location:
  • Phone: 804-852-5794
  • Fax:
Mailing address:
  • Phone: 804-852-5794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: SANDRA THOMAS CLAXTON
Title or Position: CEO
Credential:
Phone: 804-852-5794