MEDICARE: JOY OF LIVING ASSISTED CARE 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366107583
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOY OF LIVING ASSISTED CARE LLC

Provider Business Mailing Address
First Line	:	5710 COCONUT RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33413-1829
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5710 COCONUT RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33413-1829
Country	:	US
Telephone Number	:	561-478-0523
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANDREA RHODEN
Credential	:
Telephone Number	:	954-802-1051

Provider Enumeration Date	:	11/02/2021
Last Update Date	:	11/03/2021

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