Provider Demographics
NPI:1164228672
Name:TOTAL JOY SKILLED NURSING AGENCY
Entity type:Organization
Organization Name:TOTAL JOY SKILLED NURSING AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:PETTIES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-656-0558
Mailing Address - Street 1:10103 FONDREN RD STE 312
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-4650
Mailing Address - Country:US
Mailing Address - Phone:832-627-7169
Mailing Address - Fax:
Practice Address - Street 1:10103 FONDREN RD STE 312
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-4650
Practice Address - Country:US
Practice Address - Phone:832-627-7169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health