Provider Demographics
NPI:1033637384
Name:MARICK HOME CARE LLC
Entity Type:Organization
Organization Name:MARICK HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSCH-FREDERICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-248-7626
Mailing Address - Street 1:21883 N OLSON CT
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85138-9469
Mailing Address - Country:US
Mailing Address - Phone:973-248-7626
Mailing Address - Fax:
Practice Address - Street 1:3185 S PRICE RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-3562
Practice Address - Country:US
Practice Address - Phone:973-248-7626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-07
Last Update Date:2017-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care