MEDICARE: JOYFULCARE 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	385H00000X	Respite Care

General Provider Information

NPI Number	:	1588136683
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOYFULCARE HOMES LLC

Provider Business Mailing Address
First Line	:	6065 HEARTH CT
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80922-1829
Country	:	US
Telephone Number	:	719-213-5853
Fax Number	:	719-960-2219

Provider Business Practice Location Address
First Line	:	6065 HEARTH CT
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80922-1829
Country	:	US
Telephone Number	:	719-213-5853
Fax Number	:	719-960-2219

Authorized Official
Title or Position	:	CHIEF EXECUTIVE DIRECTOR
Name	:	MS. ANNIE LOUISE MABRY
Credential	:
Telephone Number	:	719-213-5853

Provider Enumeration Date	:	12/30/2018
Last Update Date	:	12/30/2018

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