Provider Demographics
NPI:1649141250
Name:ENJOYABLE LIFE ADULT FAMILY HOME
Entity type:Organization
Organization Name:ENJOYABLE LIFE ADULT FAMILY HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:EDDY
Authorized Official - Last Name:DUCASSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-458-0054
Mailing Address - Street 1:424 ELLINGTON AVE SE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-4121
Mailing Address - Country:US
Mailing Address - Phone:321-458-0054
Mailing Address - Fax:321-327-7610
Practice Address - Street 1:424 ELLINGTON AVE SE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-4121
Practice Address - Country:US
Practice Address - Phone:321-458-0054
Practice Address - Fax:321-327-7610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility