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General NPI Number Information
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NPI Number | 1033084793
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Entity Type | Organization
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Legal Business Name | JOETTA'S JOVIAL PRIVATE HOMECARE AGENCY, LLC
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Dates
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Enumeration Date | 10/10/2025
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 6900 TAVISTOCK LAKES BLVD STE 400
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City | ORLANDO
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State | FL
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Zip | 32827-7593
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Country | US
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Telephone | 404-907-4669
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Fax | 404-953-7113
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Provider Business Mailing Address
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Address Line | 6900 TAVISTOCK LAKES BLVD STE 400
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City | ORLANDO
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State | FL
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Zip | 32827-7593
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Country | US
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Telephone | 404-907-4669
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Fax | 404-953-7113
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Authorized Official
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Title or Position | CARE DIRECTOR
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Name | MRS. TIARA BOYKIN
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Credential |
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Telephone | 404-337-4570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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