Active NPI
Joy-Little Enterprise LLC
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Jacksonville, FL
National Provider Identifier
1306459359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Legal business name
- JOY-LITTLE ENTERPRISE LLC
- Practice address
- 9148 Ridge Blvd
Jacksonville, FL 32208-1265 - Phone
- (904) 683-9949
- Fax
- (904) 574-8141
- NPI assigned
- Aug 28, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lakeisha Joy Little
- Title
- Owner
- Phone
- (904) 469-5933
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Primary |
Addresses
Primary practice location
9148 Ridge Blvd
Jacksonville, FL 32208-1265
Mailing address
15744 Bainebridge Dr
Jacksonville, FL 32218-8349
Phone (904) 469-5933
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 689847596 | Medicaid | FL |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Jacksonville, FL
- NPI 1578721759
Community Based Residential Treatment Facility, Intellectual and/Or Developmental Disabilities
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598572800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598572800000",
"number": "1306459359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15744 BAINEBRIDGE DR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322188349",
"telephone_number": "904-469-5933",
"fax_number": "904-574-8141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9148 RIDGE BLVD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322081265",
"telephone_number": "904-683-9949",
"fax_number": "904-574-8141"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JOY-LITTLE ENTERPRISE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-08-28",
"last_updated": "2020-08-28",
"certification_date": "2020-08-28",
"status": "A",
"authorized_official_last_name": "LITTLE",
"authorized_official_first_name": "LAKEISHA",
"authorized_official_middle_name": "JOY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "904-469-5933"
},
"taxonomies": [
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "689847596",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.