Provider Demographics
NPI:1043757685
Name:JOIN I, LLC
Entity Type:Organization
Organization Name:JOIN I, LLC
Other - Org Name:@HEART HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHON
Authorized Official - Middle Name:
Authorized Official - Last Name:WILDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-896-5782
Mailing Address - Street 1:349 SOUTHPORT CIR STE 106
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1161
Mailing Address - Country:US
Mailing Address - Phone:757-961-4077
Mailing Address - Fax:757-802-9431
Practice Address - Street 1:349 SOUTHPORT CIR STE 106
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1161
Practice Address - Country:US
Practice Address - Phone:757-961-4077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health