Provider Demographics
NPI:1043817554
Name:JOYVIDA LLC
Entity Type:Organization
Organization Name:JOYVIDA LLC
Other - Org Name:AMADA SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:JENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-377-9121
Mailing Address - Street 1:755 HIGHWAY 105 STE D
Mailing Address - Street 2:
Mailing Address - City:PALMER LAKE
Mailing Address - State:CO
Mailing Address - Zip Code:80133-8902
Mailing Address - Country:US
Mailing Address - Phone:719-377-9121
Mailing Address - Fax:719-355-8382
Practice Address - Street 1:755 HIGHWAY 105 STE D
Practice Address - Street 2:
Practice Address - City:PALMER LAKE
Practice Address - State:CO
Practice Address - Zip Code:80133-8902
Practice Address - Country:US
Practice Address - Phone:719-377-9121
Practice Address - Fax:719-355-8382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-07
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO755105OtherINSURANCE