Provider Demographics
NPI:1225719800
Name:JOYFUL ADVENTURES LLC
Entity Type:Organization
Organization Name:JOYFUL ADVENTURES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:WIEGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:863-315-4562
Mailing Address - Street 1:PO BOX 1211
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33846-1211
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4061 PALMETTO AVE SE
Practice Address - Street 2:
Practice Address - City:HIGHLAND CITY
Practice Address - State:FL
Practice Address - Zip Code:33846
Practice Address - Country:US
Practice Address - Phone:863-315-4562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty