Provider Demographics
NPI:1982493912
Name:ELYON WORLD ASSISTED LIVING LLC
Entity type:Organization
Organization Name:ELYON WORLD ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LUCRESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKENZIE-MCPHERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-248-4331
Mailing Address - Street 1:1382 SW HALFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-6147
Mailing Address - Country:US
Mailing Address - Phone:772-248-4331
Mailing Address - Fax:
Practice Address - Street 1:1382 SW HALFORD AVE
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-6147
Practice Address - Country:US
Practice Address - Phone:772-248-4331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility