Organization
GOODWILL HOMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER LEYOU (CEO)
(202) 258-3344
Entity
Organization
Contact information
Practice address
13126 MERCURY LN, FAIRFAX, VA 22033-3711
(202) 258-3344
Mailing address
13126 MERCURY LN, FAIRFAX, VA 22033-3711
(202) 258-3344
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
07/06/2023
Last updated
09/11/2025
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