Provider Demographics
NPI:1669832127
Name:JOYFUL MEMORIES HOME HEALTH CARE
Entity type:Organization
Organization Name:JOYFUL MEMORIES HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOYCELYN
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-619-1376
Mailing Address - Street 1:18202 MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:CAPE CHARLES
Mailing Address - State:VA
Mailing Address - Zip Code:23310-4441
Mailing Address - Country:US
Mailing Address - Phone:757-619-1376
Mailing Address - Fax:757-767-3042
Practice Address - Street 1:18202 MEADOWS DR
Practice Address - Street 2:
Practice Address - City:CAPE CHARLES
Practice Address - State:VA
Practice Address - Zip Code:23310-4441
Practice Address - Country:US
Practice Address - Phone:757-619-1376
Practice Address - Fax:757-767-3042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-26
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0184978671Medicaid