Healthcare Provider Details

I. General information

NPI: 1215395249
Provider Name (Legal Business Name): A JOYFUL HEART HOME SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2016
Last Update Date: 12/15/2022
Certification Date: 12/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8324 SW 40TH ST
MIAMI FL
33155-3337
US

IV. Provider business mailing address

8324 SW 40TH ST
MIAMI FL
33155-3337
US

V. Phone/Fax

Practice location:
  • Phone: 305-417-3050
  • Fax: 786-309-9339
Mailing address:
  • Phone: 305-417-3050
  • Fax: 786-309-9339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateFL

VIII. Authorized Official

Name: ORLEY MARTINEZ
Title or Position: OWNER
Credential:
Phone: 305-417-3050