MEDICARE: LIVE IN JOY ADULT DAY CARE CORP

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

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	:	1376181388
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIVE IN JOY ADULT DAY CARE CORP

Provider Business Mailing Address
First Line	:	3001 NW 7TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-4203
Country	:	US
Telephone Number	:	786-801-0909
Fax Number	:	786-636-6145

Provider Business Practice Location Address
First Line	:	3001 NW 7TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-4203
Country	:	US
Telephone Number	:	786-801-0909
Fax Number	:	786-636-6145

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MERCEDES BARROSO
Credential	:
Telephone Number	:	786-801-0909

Provider Enumeration Date	:	12/20/2019
Last Update Date	:	12/20/2019

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