Provider Demographics
NPI:1104651454
Name:THE JOELI FOUNDATION
Entity type:Organization
Organization Name:THE JOELI FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SYKIA
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, CAC-AD, BAS
Authorized Official - Phone:443-633-3177
Mailing Address - Street 1:3211 CORPORATE CT UNIT A
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-2247
Mailing Address - Country:US
Mailing Address - Phone:443-633-3177
Mailing Address - Fax:
Practice Address - Street 1:3211 CORPORATE CT UNIT A
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-2247
Practice Address - Country:US
Practice Address - Phone:443-633-3177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE JOELI FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-05
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility