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General NPI Number Information
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NPI Number | 1316397870
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Entity Type | Organization
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Legal Business Name | JDL HEALTHCARE SERVICES, INC DBA AMADA SENIOR CARE RICHMOND WEST
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Dates
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Enumeration Date | 06/15/2016
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Last Update Date | 06/15/2016
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Provider Practice Location Address
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Address Line | 6800 PARAGON PL SUITE 106
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City | RICHMOND
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State | VA
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Zip | 23230-1649
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Country | US
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Telephone | 804-793-8255
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Fax | 804-793-8266
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Provider Business Mailing Address
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Address Line | 6800 PARAGON PL SUITE 106
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City | RICHMOND
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State | VA
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Zip | 23230-1649
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Country | US
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Telephone | 804-793-8255
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Fax | 804-793-8266
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. JAY LAWRENCE MANN
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Credential |
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Telephone | 804-793-8255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | HCO151287
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License Number State | VA
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