Healthcare Provider Details

I. General information

NPI: 1932013463
Provider Name (Legal Business Name): JOYFUL HAVEN LIVING ASSISTED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3090 BOSTEDOR RD
EATON RAPIDS MI
48827-9028
US

IV. Provider business mailing address

3090 BOSTEDOR RD
EATON RAPIDS MI
48827-9028
US

V. Phone/Fax

Practice location:
  • Phone: 517-505-6218
  • Fax:
Mailing address:
  • Phone: 517-505-6218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL

VIII. Authorized Official

Name: TAMEKIA JOELINE HENRY
Title or Position: PCA
Credential:
Phone: 517-505-6218