Provider Demographics
NPI:1316404965
Name:JOYFUL LIVING CARE
Entity Type:Organization
Organization Name:JOYFUL LIVING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CFO
Authorized Official - Prefix:
Authorized Official - First Name:SHAWNDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-490-5200
Mailing Address - Street 1:1812 W SYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43613-4639
Mailing Address - Country:US
Mailing Address - Phone:419-490-5200
Mailing Address - Fax:419-458-0544
Practice Address - Street 1:1812 W SYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43613-4639
Practice Address - Country:US
Practice Address - Phone:419-490-5200
Practice Address - Fax:419-458-0544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-01
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0274496Medicaid