JOYFUL LIVING DDA HOME, INC. (NPI# 1013042290) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013042290 |
| Entity Type | Organization |
| Organization Name | JOYFUL LIVING DDA HOME, INC. |
| Other Organization Name | JOYFUL LIVING |
| Practice Address |
115 Morton St Shelby NC 28152-6621 |
| Practice Telephone | 7044819263 |
| Practice Fax Number | 7044821692 |
| Mailing Telephone | 7044819263 |
| Mailing Fax Number | 7044821692 |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. JOSEPHINE HAYNES GRIFFIN (CLINICAL DIRECTOR OF SERVICES) |
| Authorized Official Telephone | 7044819263 |
| Authorized Official Credential | RN,BSN, QP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | MHL-023-083 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3409378 | 05 |
| Other Name | Type Code |
|---|---|
| Joyful Living | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790875730 | Joyful Living Dda Home, Inc. | Case Management | 111 Morton St, 115 Morton Street, Shelby, NC 28152-6621 | 2006-10-13 |
| Street Address |
115 MORTON ST |
| City | SHELBY |
| State | NC |
| Zip Code | 28152-6621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831720820 | The Kid Guru, LLC | Community/Behavioral Health | 6852 Landor Drive, Shelby, NC 28152 | 2020-01-29 |
| 1609370568 | Crossroads Treatment Center of Cleveland County, PC | Community/Behavioral Health | 1895 E Dixon Blvd, Shelby, NC 28152 | 2018-03-23 |
| 1184166944 | Collette Scruggs | Counselor | 200-2 South Post Road, Shelby, NC 28152 | 2016-11-10 |
| 1902277981 | Angela Hamilton Jones | Social Worker | 1243 East Dixon Blvd., Suite 4, Shelby, NC 28152 | 2015-10-15 |
| 1982002614 | Gillian Aloisia Squillacioti | Counselor | 1635 S Dekalb St, Apt 109, Shelby, NC 28152 | 2014-12-11 |
| 1578963765 | Lucy Mcdaniel | Nurse Practitioner | 200 South Post Road, Shelby, NC 28152 | 2014-08-26 |
| 1689086332 | Stanley Todd Bilin | Marriage & Family Therapist | 1243-4 East Dixon Blvd, Shelby, NC 28152 | 2014-05-29 |
| 1144512872 | Sydney M Phipps | Counselor | 1201 S Post Rd # 100, Shelby, NC 28152 | 2011-05-13 |
| 1659602928 | Katherine Ruthsatz Kjergaard | Physician Assistant | 105 East College Street, Shelby, NC 28152 | 2010-01-26 |
| 1407099229 | Cnc / Access, Inc. | Community/Behavioral Health | 1165 Country Home Road, Shelby, NC 28152 | 2009-04-09 |
| Find all providers in zip 28152 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386887693 | Trinity IIi, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 607 E Grover St, Shelby, NC 28150-4033 | 2009-04-16 |
| 1922241454 | Trinity IIi, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 605 E Grover St, Shelby, NC 28150-4033 | 2009-04-14 |
| 1194968628 | Trinity IIi, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 716 West Graham Street, Shelby, NC 28150 | 2009-04-14 |
| 1245495621 | Trinity IIi, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 921 N Lafayette St, Shelby, NC 28150-3832 | 2008-07-24 |
| 1023174448 | Blanton Home II Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2650 S Lafayette St, Shelby, NC 28152-7583 | 2006-12-29 |
| 1497819668 | Trinity IIi Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 214 North Morgan Street, Shelby, NC 28150 | 2006-12-21 |
| 1629395934 | Stout | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 605 E Grover St, Shelby, NC 28150-4033 | 2010-04-26 |
| 1003064932 | Trinity IIi Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 921 N Lafayette St, Shelby, NC 28150-3832 | 2008-09-04 |
| 1609022144 | Trinity IIi Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 921 N Lafayette St, Shelby, NC 28150-3832 | 2008-08-15 |
| 1447315833 | Trinity IIi, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 214 North Morgan Street, Shelby, NC 28150 | 2006-12-26 |
| Find all providers in SHELBY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.