Healthcare Provider Details
I. General information
NPI: 1720846843
Provider Name (Legal Business Name): MYRA JOY GREGORY TOUCH OF JOY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/12/2024
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20 E THOMAS RD
PHOENIX AZ
85012-3110
US
IV. Provider business mailing address
20 E THOMAS RD STE 2200
PHOENIX AZ
85012-3133
US
V. Phone/Fax
- Phone: 708-953-6369
- Fax:
- Phone: 708-953-6369
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MYRA
GREGORY
Title or Position: CEO
Credential:
Phone: 708-953-6469