Provider Demographics
NPI:1508556796
Name:JWK INTERNATIONAL GROUP HOMES INC
Entity Type:Organization
Organization Name:JWK INTERNATIONAL GROUP HOMES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:K
Authorized Official - Last Name:LUKWAGO
Authorized Official - Suffix:
Authorized Official - Credentials:RN-MSN
Authorized Official - Phone:240-547-7651
Mailing Address - Street 1:112 HAMLIN DR
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:22405-3371
Mailing Address - Country:US
Mailing Address - Phone:240-547-7651
Mailing Address - Fax:
Practice Address - Street 1:112 HAMLIN DR
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:VA
Practice Address - Zip Code:22405-3371
Practice Address - Country:US
Practice Address - Phone:240-547-7651
Practice Address - Fax:540-720-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities