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General NPI Number Information
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NPI Number | 1508556796
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Entity Type | Organization
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Legal Business Name | JWK INTERNATIONAL GROUP HOMES INC
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Dates
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Enumeration Date | 05/10/2023
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Last Update Date | 05/10/2023
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Provider Practice Location Address
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Address Line | 112 HAMLIN DR
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City | FALMOUTH
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State | VA
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Zip | 22405-3371
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Country | US
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Telephone | 240-547-7651
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Fax | 540-720-1001
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Provider Business Mailing Address
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Address Line | 112 HAMLIN DR
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City | FALMOUTH
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State | VA
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Zip | 22405-3371
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Country | US
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Telephone | 240-547-7651
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. HENRY K LUKWAGO
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Credential | RN-MSN
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Telephone | 240-547-7651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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