MEDICARE: JOY OF LIVING RECOVERY PROGRAM INC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1578073581
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOY OF LIVING RECOVERY PROGRAM INC

Provider Business Mailing Address
First Line	:	4716 LEIPER ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19124-3223
Country	:	US
Telephone Number	:	215-613-7121
Fax Number	:	267-343-7512

Provider Business Practice Location Address
First Line	:	4716 LEIPER ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19124-3223
Country	:	US
Telephone Number	:	215-613-7121
Fax Number	:	267-343-7512

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	SAULENE LLANES
Credential	:
Telephone Number	:	215-613-7121

Provider Enumeration Date	:	10/04/2017
Last Update Date	:	10/04/2017

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