Healthcare Provider Details

I. General information

NPI: 1275307746
Provider Name (Legal Business Name): JEWISH FOUNDATION FOR GROUP HOMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2023
Last Update Date: 06/22/2025
Certification Date: 06/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6101 EXECUTIVE BLVD STE 280
ROCKVILLE MD
20852-3910
US

IV. Provider business mailing address

6101 EXECUTIVE BLVD STE 100
ROCKVILLE MD
20852-3938
US

V. Phone/Fax

Practice location:
  • Phone: 240-283-6000
  • Fax:
Mailing address:
  • Phone: 240-283-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number
License Number StateNULL

VIII. Authorized Official

Name: MICHELE LIZEAR
Title or Position: DIRECTOR OF BUSINESS OFFICE
Credential:
Phone: 240-283-6013