=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700466984
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOY FAMILY CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/12/2021
-----------------------------------------------------
Last Update Date | 04/12/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3225 CUMBERLAND BLVD SE STE 100
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30339-6408
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-390-2263
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3225 CUMBERLAND BLVD SE STE 100
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30339-6408
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-390-2263
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | KEISHA DENISE DOWDELL
-----------------------------------------------------
Credential | ADMINISTRATOR
-----------------------------------------------------
Telephone | 678-390-2263
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------