Provider Demographics
NPI:1770891921
Name:JOY ASSISTED LIVING HOME, INC
Entity type:Organization
Organization Name:JOY ASSISTED LIVING HOME, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCDOUGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-982-1486
Mailing Address - Street 1:1390 WILLOW BEND DR
Mailing Address - Street 2:P O BOX 584
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-5805
Mailing Address - Country:US
Mailing Address - Phone:770-982-1486
Mailing Address - Fax:
Practice Address - Street 1:1390 WILLOW BEND DR
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-5805
Practice Address - Country:US
Practice Address - Phone:770-982-1486
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA067011941261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service