Provider Demographics
NPI:1255774303
Name:MJ QUALITY SERVICES INC
Entity type:Organization
Organization Name:MJ QUALITY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:MAYFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-702-3686
Mailing Address - Street 1:4441 OLD WINTER GARDEN RD
Mailing Address - Street 2:STE B
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-4251
Mailing Address - Country:US
Mailing Address - Phone:321-695-8163
Mailing Address - Fax:
Practice Address - Street 1:4441 OLD WINTER GARDEN RD
Practice Address - Street 2:STE B
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-4251
Practice Address - Country:US
Practice Address - Phone:321-695-8163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-09
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL229381251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL690257096Medicaid