Provider Demographics
NPI:1912556713
Name:JOYOUS OCASSION LLC
Entity Type:Organization
Organization Name:JOYOUS OCASSION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLIVE
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-237-2496
Mailing Address - Street 1:6755 NW MONOCO CT
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-5339
Mailing Address - Country:US
Mailing Address - Phone:772-237-2496
Mailing Address - Fax:772-237-2496
Practice Address - Street 1:6755 NW MONOCO CT
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-5339
Practice Address - Country:US
Practice Address - Phone:772-237-2496
Practice Address - Fax:772-237-2496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home