Healthcare Provider Details

I. General information

NPI: 1194453068
Provider Name (Legal Business Name): JOY HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2022
Last Update Date: 08/09/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 BLAISDELL AVE STE 200
MINNEAPOLIS MN
55404-3331
US

IV. Provider business mailing address

2400 BLAISDELL AVE STE 200
MINNEAPOLIS MN
55404-3331
US

V. Phone/Fax

Practice location:
  • Phone: 612-259-7531
  • Fax:
Mailing address:
  • Phone: 612-259-7531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: AISHA JELLE
Title or Position: OWNER
Credential:
Phone: 612-260-7901