Jan's Residential Homes

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

JAN'S RESIDENTIAL HOMES

Practice address

307 N High St
Blackstone, VA 23824-1421

Phone

(434) 676-1372

Fax

(434) 676-1062

NPI assigned

May 31, 2015

Last updated

May 31, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Judy Bennett, ADMINISTRATOR/CNA

Title

Administrator

Phone

(434) 430-0993

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433030400000",
    "number": "1700266277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 N HIGH ST",
            "city": "BLACKSTONE",
            "state": "VA",
            "postal_code": "238241421",
            "telephone_number": "434-676-1372",
            "fax_number": "434-676-1062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 N HIGH ST",
            "city": "BLACKSTONE",
            "state": "VA",
            "postal_code": "238241421",
            "telephone_number": "434-676-1372",
            "fax_number": "434-676-1062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAN'S RESIDENTIAL HOMES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-31",
        "last_updated": "2015-05-31",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "434-430-0993",
        "authorized_official_credential": "ADMINISTRATOR/CNA"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "VA",
            "license": null,
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "VA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly S Gold, LPT
• Georgeann Goldsberry
• Anizha Henderson
• Omar Sharif Higgins
• Lewis W. Irby Jr., DDS
• Christy T Johnson-Oliver, NP
• Laboratory Corporation of America Holdings
• Shantel Latta, FNP-C
• Allison Noel Lee, NP
• Madalyn Rose Lee, MD

• Adult Care Home Facility in Blackstone, VA
• Providers in Blackstone, VA by specialty
• Adult Care Home Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.