Healthcare Provider Details

I. General information

NPI: 1386762698
Provider Name (Legal Business Name): JOYFUL LEARNING CHILD ACADEMY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1935 KINGSTOWN RD
WAKEFIELD RI
02879-1616
US

IV. Provider business mailing address

1935 KINGSTOWN RD
WAKEFIELD RI
02879-1616
US

V. Phone/Fax

Practice location:
  • Phone: 401-789-2244
  • Fax: 401-789-2248
Mailing address:
  • Phone: 401-789-2244
  • Fax: 401-789-2248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number46926
License Number StateRI

VIII. Authorized Official

Name: MS. AMANDA B MATHER
Title or Position: DIRECTOR
Credential:
Phone: 401-789-2244