MEDICARE: THE ESSENCE OF JOY HOME SUPPORT 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	372600000X	Adult Companion

General Provider Information

NPI Number	:	1932077963
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE ESSENCE OF JOY HOME SUPPORT LLC

Provider Business Mailing Address
First Line	:	5807 GILCHRIST OAKS CT
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32219-3085
Country	:	US
Telephone Number	:	904-613-0858
Fax Number	:

Provider Business Practice Location Address
First Line	:	5807 GILCHRIST OAKS CT
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32219-3085
Country	:	US
Telephone Number	:	904-613-0858
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. TYRA JACKSON
Credential	:
Telephone Number	:	904-613-0858

Provider Enumeration Date	:	10/29/2025
Last Update Date	:	10/29/2025

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