Macon Mentor Academy
NPI #1609127646 in Bloomington, Indiana
Provider Information
- NPI Number
- 1609127646
- Entity Type
- Organization
- Organization Name
- Macon Mentor Academy
- Primary Specialty
- Respite Care - Respite Care, Intellectual and/or Developmental Disabilities, Child
- Enumeration Date
- Oct 1, 2012
- Last Updated
- Oct 1, 2012
Practice Location
- Address
- 3451 N KINGSLEY DR
- City
- Bloomington
- State
- Indiana
- ZIP Code
- 47404-1717
- Phone
- (317) 480-2949
Authorized Official
- Name
- MR. JERRY LEE MACON JR., K-12 EDUCATOR (BSW)
- Title
- EXECUTIVE DIRECTOR
- Phone
- (317) 480-2949
Specialties & Taxonomy Codes
| Specialty |
|---|
| Respite Care - Respite Care, Intellectual and/or Developmental Disabilities, Child — Respite Care, Intellectual and/or Developmental Disabilities, Child |
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