Healthcare Provider Details

I. General information

NPI: 1669304325
Provider Name (Legal Business Name): JEWISH FOUNDATION FOR GROUP HOMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10505 JUDICIAL DR STE 101
FAIRFAX VA
22030-5157
US

IV. Provider business mailing address

6101 EXECUTIVE BLVD STE 100
ROCKVILLE MD
20852-3938
US

V. Phone/Fax

Practice location:
  • Phone: 703-865-6830
  • Fax:
Mailing address:
  • Phone: 240-283-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

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