Provider Demographics
NPI:1265894935
Name:LOVE AND JOY RESIDENCE
Entity type:Organization
Organization Name:LOVE AND JOY RESIDENCE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:FRANCISCO
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-384-6981
Mailing Address - Street 1:1750 CANYONLANDS WAY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-4083
Mailing Address - Country:US
Mailing Address - Phone:775-384-6981
Mailing Address - Fax:775-384-6982
Practice Address - Street 1:1750 CANYONLANDS WAY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-4083
Practice Address - Country:US
Practice Address - Phone:775-384-6981
Practice Address - Fax:775-384-6982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3975AGC-14310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV9005055650Medicaid