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General NPI Number Information
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NPI Number | 1790875730
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Entity Type | Organization
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Legal Business Name | JOYFUL LIVING DDA HOME, INC.
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 111 MORTON ST 115 MORTON STREET
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City | SHELBY
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State | NC
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Zip | 28152-6621
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Country | US
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Telephone | 704-481-9263
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 13
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City | SHELBY
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State | NC
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Zip | 28151-0013
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Country | US
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Telephone | 704-481-9263
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Fax | 704-481-9263
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MRS. JOSEPHINE GRIFFIN
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Credential | RN,BSN
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Telephone | 704-481-9263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | NC
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