Provider Demographics
NPI:1801155999
Name:AGING JOYFULLY INC.
Entity type:Organization
Organization Name:AGING JOYFULLY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:ACNS-BC
Authorized Official - Phone:612-232-9446
Mailing Address - Street 1:13050 PIONEER TRL
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55347-4110
Mailing Address - Country:US
Mailing Address - Phone:952-941-2510
Mailing Address - Fax:952-942-7415
Practice Address - Street 1:13050 PIONEER TRL
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55347-4110
Practice Address - Country:US
Practice Address - Phone:952-941-2510
Practice Address - Fax:952-942-7415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-09
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3592310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility