Provider Demographics
NPI:1902097827
Name:STEIDER&CHARLES MANAGEMENT.LLC. DBA MADISON RETIREMENT CENTER.
Entity Type:Organization
Organization Name:STEIDER&CHARLES MANAGEMENT.LLC. DBA MADISON RETIREMENT CENTER.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHARLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-220-4014
Mailing Address - Street 1:251 PATRIOT LN
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-2066
Mailing Address - Country:US
Mailing Address - Phone:757-220-4014
Mailing Address - Fax:757-220-4016
Practice Address - Street 1:251 PATRIOT LN
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-2066
Practice Address - Country:US
Practice Address - Phone:757-220-4014
Practice Address - Fax:757-220-4016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAERO 2007-176310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility