Healthcare Provider Details

I. General information

NPI: 1538333927
Provider Name (Legal Business Name): FRONTIER FAMILY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2008
Last Update Date: 04/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2634 HUSSEY LN
RICHMOND VA
23223-1107
US

IV. Provider business mailing address

PO BOX 1814
MECHANICSVILLE VA
23116-0006
US

V. Phone/Fax

Practice location:
  • Phone: 804-658-4269
  • Fax:
Mailing address:
  • Phone: 804-658-4269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. LINWOOD JACOBS
Title or Position: CEO
Credential: ED.D
Phone: 804-301-1116