MEDICARE: JOY CARE HOMES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1205474236
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOY CARE HOMES LLC

Provider Business Mailing Address
First Line	:	4301 78TH AVE N
Second Line	:
City	:	BROOKLYN PARK
State	:	MN
Zip	:	55443-3403
Country	:	US
Telephone Number	:	651-354-3127
Fax Number	:	763-657-7927

Provider Business Practice Location Address
First Line	:	4301 78TH AVE N
Second Line	:
City	:	BROOKLYN PARK
State	:	MN
Zip	:	55443-3403
Country	:	US
Telephone Number	:	651-354-3127
Fax Number	:	763-657-7927

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. JOY MORABU MOBAAKI MORABU
Credential	:
Telephone Number	:	651-354-3127

Provider Enumeration Date	:	12/20/2019
Last Update Date	:	12/20/2019

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