Jilly Healthcare Services, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

JILLY HEALTHCARE SERVICES, LLC

Doing business as

Jilly Healthcare Services, LLC

Practice address

4145 Lenox Dr
Fairfax, VA 22032-1112

Phone

(202) 390-1582

NPI assigned

Aug 24, 2020

Organization subpart

No

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

Authorized official

Name

Didi Kadji-Tedjeu

Title

Owner

Phone

(202) 390-1582

Specialties & licenses 1

Addresses

Other names 1

• JILLY HEALTHCARE SERVICES, LLC Doing business as

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598227200000",
    "number": "1770196339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12642 TRAVILAH RD",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208541084",
            "telephone_number": "202-390-1582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4145 LENOX DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220321112",
            "telephone_number": "202-390-1582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JILLY HEALTHCARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-24",
        "last_updated": "2020-08-24",
        "certification_date": "2020-07-30",
        "status": "A",
        "authorized_official_last_name": "KADJI-TEDJEU",
        "authorized_official_first_name": "DIDI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "202-390-1582"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JILLY HEALTHCARE SERVICES, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James Ritchie Jezior, M.D.
• JGC Healthcare Services
• Perrin M Jhaveri, MD
• Jhia-Ming Chang, DDS, PC (iCare Family Dentistry)
• Jamie Jiao, MD
• Camila Andrea Jimenez Ardila
• Ashley Stephanie Jimenez
• Olga Lidia Jimenez, SLP
• Pukai Jin, LA.C
• Allison Marie Jiongo, FNP

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; 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.