Provider Demographics
NPI:1124584222
Name:JC HOMELIFE, INC.
Entity Type:Organization
Organization Name:JC HOMELIFE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:NETTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-869-6155
Mailing Address - Street 1:PO BOX 1600
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-9125
Mailing Address - Country:US
Mailing Address - Phone:804-869-6155
Mailing Address - Fax:804-714-1356
Practice Address - Street 1:5941 WILLOWBRANCH DR
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23234-5929
Practice Address - Country:US
Practice Address - Phone:804-869-6155
Practice Address - Fax:804-714-1356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-13
Last Update Date:2022-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)