Organization
METTHEN, INC
Active
Other names
Mona's Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELSIE MONA HENRY REGISTERED NURSE (ADMINISTRATOR)
(954) 609-8479
Entity
Organization
Contact information
Practice address
225 NW 79TH AVE, MARGATE, FL 33063-4727
(954) 609-8479
Mailing address
225 NW 79TH AVE, MARGATE, FL 33063-4727
(954) 609-8479
(954) 971-1943
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
688264196
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
688264196
MEDICAID WAIVER
FL
Enumeration date
10/17/2008
Last updated
10/17/2008
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