Provider Demographics
NPI:1679391262
Name:A JOYFUL PLACE LLC
Entity type:Organization
Organization Name:A JOYFUL PLACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:NUNGARI
Authorized Official - Last Name:KAIRU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-524-6213
Mailing Address - Street 1:23053 SE 246TH PL
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-6865
Mailing Address - Country:US
Mailing Address - Phone:425-524-6213
Mailing Address - Fax:425-660-2475
Practice Address - Street 1:23053 SE 246TH PL
Practice Address - Street 2:
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-6865
Practice Address - Country:US
Practice Address - Phone:425-524-6213
Practice Address - Fax:425-660-2475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility