MEDICARE: JOYFUL SENIOR CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1023964749
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOYFUL SENIOR CENTER LLC

Provider Business Mailing Address
First Line	:	2420 S CANAL ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60616
Country	:	US
Telephone Number	:	312-763-6213
Fax Number	:	312-763-6323

Provider Business Practice Location Address
First Line	:	2420 S CANAL ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60616
Country	:	US
Telephone Number	:	312-763-6213
Fax Number	:	312-763-6323

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	HUAN YI FANG
Credential	:
Telephone Number	:	312-823-7770

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/05/2026

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