Provider Demographics
NPI:1316397870
Name:JDL HEALTHCARE SERVICES, INC DBA AMADA SENIOR CARE RICHMOND WEST
Entity Type:Organization
Organization Name:JDL HEALTHCARE SERVICES, INC DBA AMADA SENIOR CARE RICHMOND WEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-793-8255
Mailing Address - Street 1:6800 PARAGON PL
Mailing Address - Street 2:SUITE 106
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-1649
Mailing Address - Country:US
Mailing Address - Phone:804-793-8255
Mailing Address - Fax:804-793-8266
Practice Address - Street 1:6800 PARAGON PL
Practice Address - Street 2:SUITE 106
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-1649
Practice Address - Country:US
Practice Address - Phone:804-793-8255
Practice Address - Fax:804-793-8266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO151287253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care