Provider Demographics
NPI:1407353840
Name:JOYFUL HOME CORPORATION
Entity Type:Organization
Organization Name:JOYFUL HOME CORPORATION
Other - Org Name:JOYFUL HOME IV
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DIZON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-279-1700
Mailing Address - Street 1:5 SEVEN KINGS PL
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-6232
Mailing Address - Country:US
Mailing Address - Phone:949-279-1700
Mailing Address - Fax:949-916-4720
Practice Address - Street 1:25002 HENDON ST
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-4629
Practice Address - Country:US
Practice Address - Phone:949-588-0830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA306003478310400000X
CA3060033963104A0630X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility