Organization
JEFFON SENIR CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LUCAS N FON (DIRECTOR)
(240) 461-8569
Entity
Organization
Contact information
Practice address
2620 BERRYWOOD LN, SPRINGDALE, MD 20774-7514
(240) 770-7921
Mailing address
2620 BERRYWOOD LN, SPRINGDALE, MD 20774-7514
(240) 770-7921
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
060909
MD
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
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