Healthcare Provider Details

I. General information

NPI: 1235607607
Provider Name (Legal Business Name): JOYNHOME PRIVATE CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2018
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 AYLESBURY DR
EVANS GA
30809-8215
US

IV. Provider business mailing address

1414 AYLESBURY DR
EVANS GA
30809-8215
US

V. Phone/Fax

Practice location:
  • Phone: 706-339-9984
  • Fax: 706-210-4990
Mailing address:
  • Phone: 706-339-9984
  • Fax: 706-210-4990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KENNETH ERONDU
Title or Position: ADMINISTRATOR
Credential:
Phone: 706-339-9984