Provider Demographics
NPI:1013744689
Name:JOYRIDE ENTERTAINMENT LLC
Entity type:Organization
Organization Name:JOYRIDE ENTERTAINMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-347-6123
Mailing Address - Street 1:7403 YORKSHIRE PL
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71129-3426
Mailing Address - Country:US
Mailing Address - Phone:318-347-6123
Mailing Address - Fax:
Practice Address - Street 1:7403 YORKSHIRE PL
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71129-3426
Practice Address - Country:US
Practice Address - Phone:318-347-6123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)