Provider Demographics
NPI:1275265647
Name:MJJ HOMES, LLC
Entity Type:Organization
Organization Name:MJJ HOMES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PRESCILA
Authorized Official - Middle Name:SANTOS
Authorized Official - Last Name:BARRIOS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:714-296-5135
Mailing Address - Street 1:23 MARINER CV
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-1662
Mailing Address - Country:US
Mailing Address - Phone:714-296-5135
Mailing Address - Fax:714-229-1936
Practice Address - Street 1:207 N BEL AIR ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-6205
Practice Address - Country:US
Practice Address - Phone:714-828-5117
Practice Address - Fax:714-236-5205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-25
Last Update Date:2022-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities