Provider Demographics
NPI:1184080400
Name:JOY PCA SERVICE
Entity type:Organization
Organization Name:JOY PCA SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-778-7961
Mailing Address - Street 1:5700 FLORIDA BLVD STE 1210
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-4277
Mailing Address - Country:US
Mailing Address - Phone:225-778-7961
Mailing Address - Fax:225-778-7963
Practice Address - Street 1:5700 FLORIDA BLVD STE 1210
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-4277
Practice Address - Country:US
Practice Address - Phone:225-778-7961
Practice Address - Fax:225-778-7963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2203782082253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care