Provider Demographics
NPI:1407002033
Name:NUZON CORPORATION
Entity Type:Organization
Organization Name:NUZON CORPORATION
Other - Org Name:QUINTANA HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LILIBETH
Authorized Official - Middle Name:D
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:949-292-8261
Mailing Address - Street 1:19 AURORE AVE
Mailing Address - Street 2:
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-2321
Mailing Address - Country:US
Mailing Address - Phone:949-916-9234
Mailing Address - Fax:949-916-1646
Practice Address - Street 1:24522 QUINTANA DRIVE
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691
Practice Address - Country:US
Practice Address - Phone:949-916-9234
Practice Address - Fax:949-916-1646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities