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General NPI Number Information
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NPI Number | 1154662518
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Entity Type | Organization
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Legal Business Name | JOYFUL LIVING AT HOME LLC
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Dates
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Enumeration Date | 03/11/2013
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Last Update Date | 03/11/2013
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Provider Practice Location Address
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Address Line | 7513 PRESIDENTIAL LN
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City | MANASSAS
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State | VA
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Zip | 20109-2628
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Country | US
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Telephone | 703-349-5081
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Fax |
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Provider Business Mailing Address
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Address Line | 4427 FOREST HILL DR
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City | FAIRFAX
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State | VA
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Zip | 22030-5601
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Country | US
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Telephone | 703-218-1841
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JILL ROSEN
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Credential |
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Telephone | 703-349-5081
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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 | HCO13903
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License Number State | VA
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