Provider Demographics
NPI:1477609048
Name:J & D RESIDENTIAL SERVICES, INC.
Entity Type:Organization
Organization Name:J & D RESIDENTIAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
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 1:9906 REMORA DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23237-3923
Mailing Address - Country:US
Mailing Address - Phone:804-869-6155
Mailing Address - Fax:804-706-6167
Practice Address - Street 1:9906 REMORA DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23237-3923
Practice Address - Country:US
Practice Address - Phone:804-869-6155
Practice Address - Fax:804-706-6167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA497320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities