Healthcare Provider Details

I. General information

NPI: 1972283372
Provider Name (Legal Business Name): JOY AND LOVE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2023
Last Update Date: 07/20/2023
Certification Date: 07/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1178 EVERGREEN LN
VISTA CA
92084-1015
US

IV. Provider business mailing address

1178 EVERGREEN LN
VISTA CA
92084-1015
US

V. Phone/Fax

Practice location:
  • Phone: 661-754-0261
  • Fax:
Mailing address:
  • Phone: 661-754-0261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. SIVAGANESH VENKATA MULLAPUDI
Title or Position: CEO
Credential: MS, MBA
Phone: 661-754-0261