Provider Demographics
NPI:1356593693
Name:JACKSON-FEILD HOMES
Entity type:Organization
Organization Name:JACKSON-FEILD HOMES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-355-8735
Mailing Address - Street 1:205 NORTH BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-4006
Mailing Address - Country:US
Mailing Address - Phone:804-355-8735
Mailing Address - Fax:434-348-3471
Practice Address - Street 1:205 NORTH BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-4006
Practice Address - Country:US
Practice Address - Phone:804-355-8735
Practice Address - Fax:434-348-3471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-17
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children