Organization Active NPI

Fairfax County Group Homes LLC

  • Developmentally Disabled Services Day Training Agency
  • Falls Church, VA
National Provider Identifier
1053240713
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
FAIRFAX COUNTY GROUP HOMES LLC
Practice address
804 Randolph St
Falls Church, VA 22046-2811
Phone
(703) 209-5160
Fax
(571) 441-6247
NPI assigned
May 18, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Deepa Gill
Title
Owner
Phone
(703) 209-5160

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

804 Randolph St
Falls Church, VA 22046-2811

Mailing address

804 Randolph St
Falls Church, VA 22046-2811
Phone (703) 209-5160

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1779062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779062400000",
    "number": "1053240713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 RANDOLPH ST",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220462811",
            "telephone_number": "703-209-5160",
            "fax_number": "571-441-6247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 RANDOLPH ST",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220462811",
            "telephone_number": "703-209-5160",
            "fax_number": "571-441-6247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFAX COUNTY GROUP HOMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-18",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "DEEPA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-209-5160"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.