MEDICARE: JOY ETC, INC

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	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1306629803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOY ETC, INC

Provider Business Mailing Address
First Line	:	PO BOX 488
Second Line	:
City	:	ELLENBORO
State	:	NC
Zip	:	28040-0488
Country	:	US
Telephone Number	:	828-453-0608
Fax Number	:	828-453-0608

Provider Business Practice Location Address
First Line	:	113 BEACON HL
Second Line	:
City	:	ELLENBORO
State	:	NC
Zip	:	28040-7645
Country	:	US
Telephone Number	:	828-453-0608
Fax Number	:	828-453-0608

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	JOY COOPER WILLIAMS
Credential	:
Telephone Number	:	828-453-0608

Provider Enumeration Date	:	08/17/2023
Last Update Date	:	08/17/2023

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