Provider Demographics
NPI:1861080871
Name:JOYFUL HEART ADULT DAY CENTER LLC
Entity type:Organization
Organization Name:JOYFUL HEART ADULT DAY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:L
Authorized Official - Last Name:TORREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-718-3546
Mailing Address - Street 1:12201 PEMBROKE RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-1725
Mailing Address - Country:US
Mailing Address - Phone:754-210-3374
Mailing Address - Fax:954-362-4923
Practice Address - Street 1:12201 PEMBROKE RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025-1725
Practice Address - Country:US
Practice Address - Phone:754-210-3374
Practice Address - Fax:954-362-4923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-05
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108121900Medicaid