Provider Demographics
NPI:1962235333
Name:STREAMS OF JOY RESIDENTIAL HOME LLC
Entity type:Organization
Organization Name:STREAMS OF JOY RESIDENTIAL HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:E
Authorized Official - Last Name:EREGIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-203-3070
Mailing Address - Street 1:2622 MAPLE LEAF DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-1730
Mailing Address - Country:US
Mailing Address - Phone:682-203-3070
Mailing Address - Fax:817-459-1224
Practice Address - Street 1:2622 MAPLE LEAF DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-1730
Practice Address - Country:US
Practice Address - Phone:682-203-3070
Practice Address - Fax:817-459-1224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility