MEDICARE: A JOYFUL HEART HOME SERVICES II 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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1548879406
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A JOYFUL HEART HOME SERVICES II LLC

Provider Business Mailing Address
First Line	:	2991 FOREST HILL BLVD UNIT 4
Second Line	:
City	:	PALM SPRINGS
State	:	FL
Zip	:	33406-5921
Country	:	US
Telephone Number	:	561-223-0271
Fax Number	:

Provider Business Practice Location Address
First Line	:	2991 FOREST HILL BLVD UNIT 4
Second Line	:
City	:	PALM SPRINGS
State	:	FL
Zip	:	33406-5921
Country	:	US
Telephone Number	:	561-223-0271
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MS. ROXANA MOREJON
Credential	:
Telephone Number	:	561-223-0271

Provider Enumeration Date	:	07/27/2020
Last Update Date	:	07/27/2020

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