Provider Demographics
NPI:1447944475
Name:1 JOYFUL ADULT FAMILY HOME LLC
Entity type:Organization
Organization Name:1 JOYFUL ADULT FAMILY HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:BISHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-313-4816
Mailing Address - Street 1:1826 N 198TH ST
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-3711
Mailing Address - Country:US
Mailing Address - Phone:206-313-4816
Mailing Address - Fax:
Practice Address - Street 1:16919 29TH DR SE
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98012-6628
Practice Address - Country:US
Practice Address - Phone:425-485-9100
Practice Address - Fax:425-949-8234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home