Healthcare Provider Details

I. General information

NPI: 1477422939
Provider Name (Legal Business Name): TRJ ENTERPRISE AND COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

446 BRADSHAW CT
LILBURN GA
30047-5939
US

IV. Provider business mailing address

446 BRADSHAW CT
LILBURN GA
30047-5939
US

V. Phone/Fax

Practice location:
  • Phone: 404-938-7782
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: LEAH TILLER
Title or Position: CEO
Credential:
Phone: 404-938-7782