MEDICARE: LIVED JOYS 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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1679454417
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIVED JOYS LLC

Provider Business Mailing Address
First Line	:	1349 E FREMONT RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85042-5673
Country	:	US
Telephone Number	:	864-621-1130
Fax Number	:

Provider Business Practice Location Address
First Line	:	1349 E FREMONT RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85042-5673
Country	:	US
Telephone Number	:	864-621-1130
Fax Number	:

Authorized Official
Title or Position	:	CHIEF ADMINISTRATIVE OFFICER
Name	:	NATACHA KIMENYI
Credential	:
Telephone Number	:	864-621-1130

Provider Enumeration Date	:	09/09/2025
Last Update Date	:	09/09/2025

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Directions to “LIVED JOYS LLC ” Practice Location

Language	Start Address	Practice Location

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