Healthcare Provider Details

I. General information

NPI: 1780270454
Provider Name (Legal Business Name): PARADISE OF JOY HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2020
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 HYW 84 WEST 1212 HYW 84 WEST
CAIRO GA GA
39828
US

IV. Provider business mailing address

122 N BROAD ST
CAIRO GA
39828-2105
US

V. Phone/Fax

Practice location:
  • Phone: 122-397-0380
  • Fax: 229-397-0381
Mailing address:
  • Phone: 229-397-0380
  • Fax: 229-397-0381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: VENTRISHA LINETT MOLLINS
Title or Position: OWNER
Credential:
Phone: 229-397-0380