Provider Demographics
NPI:1821226879
Name:MARJON ENTERPRISES LLC
Entity Type:Organization
Organization Name:MARJON ENTERPRISES LLC
Other - Org Name:OCCUPATIONAL THERAPY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARJORIE
Authorized Official - Middle Name:P
Authorized Official - Last Name:BLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:619-922-6480
Mailing Address - Street 1:PO BOX 60325
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92166-8325
Mailing Address - Country:US
Mailing Address - Phone:619-922-6480
Mailing Address - Fax:866-695-4997
Practice Address - Street 1:9606 TIERRA GRANDE
Practice Address - Street 2:SUITE 104 / 107
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-6501
Practice Address - Country:US
Practice Address - Phone:619-922-6480
Practice Address - Fax:866-695-4997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-29
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 5033252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency