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General NPI Number Information
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NPI Number | 1346548856
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Entity Type | Organization
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Legal Business Name | JOY PERSONAL CARE HOME
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Dates
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Enumeration Date | 03/08/2011
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Last Update Date | 03/08/2011
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Provider Practice Location Address
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Address Line | 5895 BRANCH VALLEY WAY
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City | CUMMING
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State | GA
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Zip | 30040-7090
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Country | US
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Telephone | 770-906-3573
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Fax | 678-947-4850
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Provider Business Mailing Address
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Address Line | 5895 BRANCH VALLEY WAY
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City | CUMMING
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State | GA
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Zip | 30040-7090
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Country | US
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Telephone | 770-906-3573
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Fax | 678-947-4850
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Authorized Official
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Title or Position | CEO
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Name | JOYCE AFRIYIE
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Credential |
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Telephone | 770-906-3573
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number | 058-01-015-1
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | 058-01-015-1
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License Number State | GA
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