MEDICARE: JOYFUL HOME FAMILY CARE

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	310400000X	Assisted Living Facility	FCL-081-032	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255458063
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOYFUL HOME FAMILY CARE

Provider Business Mailing Address
First Line	:	PO BOX 488
Second Line	:
City	:	ELLENBORO
State	:	NC
Zip	:	28040-0488
Country	:	US
Telephone Number	:	828-453-0608
Fax Number	:

Provider Business Practice Location Address
First Line	:	113 BEACON HL
Second Line	:
City	:	ELLENBORO
State	:	NC
Zip	:	28040-7645
Country	:	US
Telephone Number	:	828-453-0608
Fax Number	:

Authorized Official
Title or Position	:	OWNER ADMINISTRATOR
Name	:	JOY COOPER WILLIAMS
Credential	:
Telephone Number	:	828-453-0608

Provider Enumeration Date	:	03/25/2007
Last Update Date	:	05/06/2008

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