Provider Demographics
NPI:1730371568
Name:JOY IMPACT OUTREACH MINISTRIES, INC.
Entity type:Organization
Organization Name:JOY IMPACT OUTREACH MINISTRIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KELVIN
Authorized Official - Middle Name:G
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-278-2664
Mailing Address - Street 1:PO BOX 592
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:LA
Mailing Address - Zip Code:71251-0592
Mailing Address - Country:US
Mailing Address - Phone:318-278-2664
Mailing Address - Fax:
Practice Address - Street 1:1707 E MAIN ST
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:LA
Practice Address - Zip Code:71251-5412
Practice Address - Country:US
Practice Address - Phone:318-278-2664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health