Provider Demographics
NPI:1477247385
Name:EVERJOY GROUP HOME LLC
Entity Type:Organization
Organization Name:EVERJOY GROUP HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:ASIEDUA
Authorized Official - Last Name:LETSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-484-2054
Mailing Address - Street 1:681 HOPE RD
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-5225
Mailing Address - Country:US
Mailing Address - Phone:571-484-2054
Mailing Address - Fax:571-298-8065
Practice Address - Street 1:681 HOPE RD
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-5225
Practice Address - Country:US
Practice Address - Phone:571-484-2054
Practice Address - Fax:571-298-8065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities