JILLY HEALTHCARE SERVICES, LLC (NPI# 1770196339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770196339 |
| Entity Type | Organization |
| Organization Name | JILLY HEALTHCARE SERVICES, LLC |
| Practice Address |
4145 Lenox Dr Fairfax VA 22032-1112 |
| Mailing Address |
12642 Travilah Rd Potomac MD 20854-1084 |
| Practice Telephone | 2023901582 |
| Mailing Telephone | 2023901582 |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2020-08-24 |
| Authorized Official Name | DIDI KADJI-TEDJEU (OWNER) |
| Authorized Official Telephone | 2023901582 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| JILLY HEALTHCARE SERVICES, LLC | Doing Business As Name - Organization |
| Street Address |
4145 LENOX DR |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22032-1112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093193567 | Cynthia Leigh Pascal | Counselor | 9801 Joyce Street, Fairfax, VA 22032 | 2015-05-15 |
| 1760888432 | Judy Lim | Massage Therapist | 4205 Olley Ln, Fairfax, VA 22032 | 2014-11-07 |
| 1083015010 | Caring Heart Nursing Services LLC | Registered Nurse | 4824 Gainsborough Dr, Fairfax, VA 22032 | 2014-09-09 |
| 1033483839 | Inovacares for Seniors | PACE Provider Organization | 4027b Olley Lane, Braddock Glen, Fairfax, VA 22032 | 2012-02-27 |
| 1598032716 | Joshua Michael Prozeralik | Pharmacist | 10310 New Guinea Road, Burke, VA 22032 | 2011-11-17 |
| 1356570071 | Azmy A. Iskander | Emergency Medicine | 10520 Acacia Lane, Fairfax, VA 22032 | 2009-07-02 |
| 1851515175 | The Pediatric Group, PC | Registered Nurse | 10527 Braddock Road, Fairfax, VA 22032 | 2007-04-11 |
| 1770634313 | Andrea L Lubeck | Nurse Practitioner | 10301 New Guinea Road, Cvs Health, Minuteclinic, Fairfax, VA 22032 | 2007-01-12 |
| 1104167212 | Inova Health Care Services | PACE Provider Organization | 4027b Olley Lane, Braddock Glen, Fairfax, VA 22032 | 2013-03-14 |
| 1770835993 | Catherine A Groden | Nurse Practitioner | 10301 New Guinea Rd, Target, Fairfax, VA 22032 | 2012-10-11 |
| Find all providers in zip 22032 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790317105 | Zrahil Healthcare LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10905 Fairchester Dr, Fairfax, VA 22030-4807 | 2020-02-04 |
| 1790321800 | Community Comfort Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3736 Richard Ave, Fairfax, VA 22031-3535 | 2019-11-24 |
| 1609410273 | Hands of Mercy Group Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 12783 Cruz Ct, Fairfax, VA 22030-7283 | 2019-11-06 |
| 1114400157 | Divine Supports & Homes Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 13005 Maepine Ct, Fairfax, VA 22033-3130 | 2018-09-14 |
| 1568965333 | William Henry Barnes | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3112 Plantation Pkwy, Fairfax, VA 22030-2118 | 2018-03-17 |
| 1427400050 | Compassionate Care Group Homes, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4413 San Carlos Dr, Fairfax, VA 22030-5372 | 2016-07-07 |
| 1922191121 | Community Living Alternatives, Corp. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9401 Lee Hwy, Suite 406, Fairfax, VA 22031-1849 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134729213 | Saint Claire Healthcare | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5601 Seminary Rd Apt 915n, Falls Church, VA 22041-2997 | 2020-10-28 |
| 1780283275 | Great Day Residential | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6606 Gills Gate Pl, Chesterfield, VA 23832-6004 | 2020-10-26 |
| 1306451448 | Nikita S Banks | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 505 Cumberland Street Ave, Ste 2, Portsmouth, VA 23704-2370 | 2020-09-15 |
| 1396359576 | Best Hope Community Residential Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9662 Hawkshead Dr, Lorton, VA 22079-2786 | 2020-09-03 |
| 1609489038 | Viana Healthcare Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8205 Mockingbird Dr, Annandale, VA 22003-3713 | 2020-08-25 |
| 1225640279 | Guardian Angels Homecare, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1116 Pin Oak Drive, Suffolk, VA 23434-2343 | 2020-08-20 |
| 1659993079 | Collaborative Community LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6000 Filbert Ct, Springfield, VA 22152-1609 | 2020-05-07 |
| 1356962252 | Intellectual Services Group, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4813 Integrity Ct, Fredericksburg, VA 22408-1891 | 2020-05-01 |
| 1699394346 | Peace of Mind Residential Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 17 Pinehurst Ln, Stafford, VA 22554-7288 | 2020-04-13 |
| 1487282729 | Eye Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 721 Cabin Creek Dr, Hopewell, VA 23860-5350 | 2020-03-31 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on JILLY HEALTHCARE SERVICES, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.