Provider Demographics
NPI:1346548856
Name:JOY PERSONAL CARE HOME
Entity Type:Organization
Organization Name:JOY PERSONAL CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:AFRIYIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-906-3573
Mailing Address - Street 1:5895 BRANCH VALLEY WAY
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-7090
Mailing Address - Country:US
Mailing Address - Phone:770-906-3573
Mailing Address - Fax:678-947-4850
Practice Address - Street 1:5895 BRANCH VALLEY WAY
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-7090
Practice Address - Country:US
Practice Address - Phone:770-906-3573
Practice Address - Fax:678-947-4850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA058-01-015-1320600000X, 320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities