Healthcare Provider Details

I. General information

NPI: 1124538228
Provider Name (Legal Business Name): JOYFUL HEARTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2017
Last Update Date: 09/14/2020
Certification Date: 09/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7475 CADES CV
MEMPHIS TN
38125-5019
US

IV. Provider business mailing address

7475 CADES CV
MEMPHIS TN
38125-5019
US

V. Phone/Fax

Practice location:
  • Phone: 901-833-8156
  • Fax:
Mailing address:
  • Phone: 901-833-8156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MAXINE SIMS
Title or Position: OWNER
Credential:
Phone: 901-833-8156