Provider Demographics
NPI:1265215008
Name:THE JAVA GROUP LLC
Entity type:Organization
Organization Name:THE JAVA GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:JANIGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-222-7388
Mailing Address - Street 1:110 EVANS MILL DR STE 801
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30157-1642
Mailing Address - Country:US
Mailing Address - Phone:770-222-7388
Mailing Address - Fax:
Practice Address - Street 1:110 EVANS MILL DR STE 801
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30157-1642
Practice Address - Country:US
Practice Address - Phone:770-222-7388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care