Provider Demographics
NPI:1538333927
Name:FRONTIER FAMILY SERVICES LLC
Entity type:Organization
Organization Name:FRONTIER FAMILY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LINWOOD
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:804-301-1116
Mailing Address - Street 1:PO BOX 1814
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-0006
Mailing Address - Country:US
Mailing Address - Phone:804-658-4269
Mailing Address - Fax:
Practice Address - Street 1:2634 HUSSEY LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-1107
Practice Address - Country:US
Practice Address - Phone:804-658-4269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility