MEDICARE: JOY HOME CARE 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	251E00000X	Home Health Agency	HCO 171420	VA

General Provider Information

NPI Number	:	1376907279
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOY HOME CARE LLC

Provider Business Mailing Address
First Line	:	3824 VIRGINIA BEACH BLVD
Second Line	:	202
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-2438
Country	:	US
Telephone Number	:	757-512-7722
Fax Number	:	844-469-7537

Provider Business Practice Location Address
First Line	:	3824 VIRGINIA BEACH BLVD
Second Line	:	202
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-2438
Country	:	US
Telephone Number	:	757-512-7722
Fax Number	:	757-351-2869

Authorized Official
Title or Position	:	OWNER
Name	:	HOLLY ELIZABETH ENGELBRECHT
Credential	:
Telephone Number	:	757-470-8834

Provider Enumeration Date	:	04/07/2016
Last Update Date	:	12/29/2016

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