Provider Demographics
NPI:1619015112
Name:JOYLAND HOMES, INC
Entity type:Organization
Organization Name:JOYLAND HOMES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:DUNSTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:919-602-3455
Mailing Address - Street 1:15 HOWLETT PL
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-3365
Mailing Address - Country:US
Mailing Address - Phone:919-381-9761
Mailing Address - Fax:919-598-1989
Practice Address - Street 1:15 HOWLETT PL
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-3365
Practice Address - Country:US
Practice Address - Phone:919-381-9761
Practice Address - Fax:919-598-1989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-032-343320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCMHL-032-343OtherMENTAL HEALTH LICENSE #
NC6603923Medicaid