Provider Demographics
NPI:1083891113
Name:MAR-C INDUSTRIES
Entity Type:Organization
Organization Name:MAR-C INDUSTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CONTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:ACCOUNTANT
Authorized Official - Phone:318-377-4774
Mailing Address - Street 1:1400 COMMERCE STREET
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-0423
Mailing Address - Country:US
Mailing Address - Phone:318-377-4774
Mailing Address - Fax:318-377-4799
Practice Address - Street 1:1400 COMMERCE STREET
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-0423
Practice Address - Country:US
Practice Address - Phone:318-377-4774
Practice Address - Fax:318-377-4799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAADC2322251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1937762Medicaid