Provider Demographics
NPI:1265662589
Name:JEROLIN MANAGEMENT SERVICES, LLC
Entity Type:Organization
Organization Name:JEROLIN MANAGEMENT SERVICES, LLC
Other - Org Name:RESIDENTIAL SERVICES AT RIVERS BEND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:804-530-5620
Mailing Address - Street 1:PO BOX 3106
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-8458
Mailing Address - Country:US
Mailing Address - Phone:804-530-5620
Mailing Address - Fax:
Practice Address - Street 1:9 W HUNDRED RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23836-2501
Practice Address - Country:US
Practice Address - Phone:804-530-5620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA777-08-011251C00000X
VA777-03-001251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services