Provider Demographics
NPI:1023702487
Name:A DIFFERENT WORLD HOME SERVICES LLC
Entity type:Organization
Organization Name:A DIFFERENT WORLD HOME SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:JEUDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-405-5546
Mailing Address - Street 1:3309 GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-1917
Mailing Address - Country:US
Mailing Address - Phone:845-405-5546
Mailing Address - Fax:
Practice Address - Street 1:10400 CHESTER RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-1201
Practice Address - Country:US
Practice Address - Phone:845-405-5546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-07
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services