# JEFFON SENIR CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265628085
- **Authorized official:** MR. LUCAS N FON (DIRECTOR)
- **Authorized official phone:** (240) 461-8569

## Contact information

- **Practice address:** 2620 BERRYWOOD LN, SPRINGDALE, MD 20774-7514
- **Practice address phone:** (240) 770-7921
- **Mailing address:** 2620 BERRYWOOD LN, SPRINGDALE, MD 20774-7514
- **Mailing address phone:** (240) 770-7921

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 060909 | MD | Yes |
| 251J00000X | Nursing Care Agency | 0609009 | MD | — |
| 320800000X | Mental Illness Community Based Residential Treatment Facility | 060909 | MD | — |

## Other

- **Enumeration date:** 09/16/2007
- **Last updated:** 09/16/2007