Provider Demographics
NPI:1780357855
Name:HEAVENLY JOY HOME CARE LLC
Entity type:Organization
Organization Name:HEAVENLY JOY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:JURUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-730-7107
Mailing Address - Street 1:635 EL TORA CV S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-1081
Mailing Address - Country:US
Mailing Address - Phone:701-730-7107
Mailing Address - Fax:
Practice Address - Street 1:635 EL TORA CV S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-1081
Practice Address - Country:US
Practice Address - Phone:701-730-7107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care