Provider Demographics
NPI:1043917818
Name:HEART OF JOY LLC
Entity Type:Organization
Organization Name:HEART OF JOY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:GERHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLAZZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-651-1177
Mailing Address - Street 1:2935 HOLLY POINT DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-3508
Mailing Address - Country:US
Mailing Address - Phone:904-651-1177
Mailing Address - Fax:
Practice Address - Street 1:2935 HOLLY POINT DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32277-3508
Practice Address - Country:US
Practice Address - Phone:904-651-1177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002327300Medicaid