=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457494387
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GENJOY CARE COMMUNITIES, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/14/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18 HORSE BARN ROAD
-----------------------------------------------------
City | CANDLER
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28715
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-670-8895
-----------------------------------------------------
Fax | 828-670-8894
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1180
-----------------------------------------------------
City | CANDLER
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28715-1180
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-670-8895
-----------------------------------------------------
Fax | 828-670-8894
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MRS. DEBRA LYNNE WRIGHT-BROWER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 828-670-8895
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 311ZA0620X
-----------------------------------------------------
Taxonomy Name | Adult Care Home Facility
-----------------------------------------------------
License Number | HAL-011-031
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------