Provider Demographics
NPI:1598196578
Name:JOYFUL LIVING, LLC
Entity Type:Organization
Organization Name:JOYFUL LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DESIGNATED MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-830-1499
Mailing Address - Street 1:4027 FLANDRE COVE CT
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63034-2252
Mailing Address - Country:US
Mailing Address - Phone:314-830-1499
Mailing Address - Fax:
Practice Address - Street 1:4027 FLANDRE COVE CT
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63034-2252
Practice Address - Country:US
Practice Address - Phone:314-830-1499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care