Provider Demographics
NPI:1689815490
Name:THE JOSHUA GROUP LLC
Entity Type:Organization
Organization Name:THE JOSHUA GROUP LLC
Other - Org Name:SERENITY HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:407-701-7037
Mailing Address - Street 1:3564 AVALON PARK BLVD E
Mailing Address - Street 2:STE 1-263
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7365
Mailing Address - Country:US
Mailing Address - Phone:407-701-7037
Mailing Address - Fax:407-264-8710
Practice Address - Street 1:3564 AVALON PARK BLVD E
Practice Address - Street 2:SUITE 1 #263
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-4822
Practice Address - Country:US
Practice Address - Phone:407-701-7037
Practice Address - Fax:407-264-8710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL229883253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL693027100Medicaid