Provider Demographics
NPI:1891020426
Name:PASTIVA, JOYCE ANN
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:ANN
Last Name:PASTIVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1481 SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242-9409
Mailing Address - Country:US
Mailing Address - Phone:517-437-0327
Mailing Address - Fax:
Practice Address - Street 1:1481 SOUTH DR
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-9409
Practice Address - Country:US
Practice Address - Phone:517-437-0327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI93082076Medicaid