Provider Demographics
NPI:1053757294
Name:DESMORNES, JOSEPH
Entity type:Organization
Organization Name:DESMORNES, JOSEPH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:DESMORNES
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:239-204-6373
Mailing Address - Street 1:2621 SW 37TH TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-4888
Mailing Address - Country:US
Mailing Address - Phone:239-204-6373
Mailing Address - Fax:239-541-9405
Practice Address - Street 1:2621 SW 37TH TER
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-4888
Practice Address - Country:US
Practice Address - Phone:239-204-6373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-15
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6906581311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home