GOODWILL HOMES LLC NPI 1154001139

NPI Information

NPI: 1154001139
Provider Name: GOODWILL HOMES LLC
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
13126 MERCURY LN
FAIRFAX, VA
ZIP 22033
Phone: (202) 258-3344
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GOODWILL HOMES LLC is a community based residential treatment facility, intellectual and/or developmental disabilities in Fairfax, VA. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. GOODWILL HOMES LLC NPI is 1154001139. The provider is registered as an organization entity type.

The provider's business location address is:

13126 MERCURY LN
FAIRFAX, VA
ZIP 22033-711
Phone: (202) 258-3344

The provider's authorized official is Roger E Leyou .
The authorized official title is Director and has the following contact phone number (202) 258-3344.

The enumeration date for this NPI number is 7/24/2023 and was last updated on 7/24/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	253Z00000X	In Home Supportive Care		No
2	385H00000X	Respite Care		No
3	385HR2060X	Respite Care	Respite Care, Intellectual and/or Developmental Disabilities	No
4	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities		Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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