Provider Demographics
NPI:1114056249
Name:MARSHALL MANOR HOMECARE, LLC
Entity Type:Organization
Organization Name:MARSHALL MANOR HOMECARE, LLC
Other - Org Name:MARSHALL MANOR HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADVISORY BOARD MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:BENSON
Authorized Official - Last Name:CHAMBERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:903-935-7971
Mailing Address - Street 1:111 E BURLESON ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:TX
Mailing Address - Zip Code:75670-3312
Mailing Address - Country:US
Mailing Address - Phone:903-923-8154
Mailing Address - Fax:903-923-8624
Practice Address - Street 1:111 E BURLESON ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:TX
Practice Address - Zip Code:75670-3312
Practice Address - Country:US
Practice Address - Phone:903-923-8154
Practice Address - Fax:903-923-8624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009761251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based