Organization
LENORA MAZON
Active
Organization
LENORA MAZON
Active
Other names
Lenora Mazon Med Waiver & Nursing
Organization subpart
No
Provider details
NPI number
Authorized official
LENORA MAZON (OWNER/ ADMINISTRATIVE COORDINATOR)
(352) 318-9681
Entity
Organization
Contact information
Practice address
211 E 10TH AVE, HAVANA, FL 32333-1915
(352) 318-9681
Mailing address
211 E 10TH AVE, HAVANA, FL 32333-1915
(352) 318-9681
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
06/15/2016
Last updated
10/25/2016
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