Provider Demographics
NPI:1265832976
Name:MARY'S LOVE-N-CARE LLC
Entity Type:Organization
Organization Name:MARY'S LOVE-N-CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-942-7048
Mailing Address - Street 1:6350 EL SERRANO DR
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63033-8120
Mailing Address - Country:US
Mailing Address - Phone:314-942-7048
Mailing Address - Fax:
Practice Address - Street 1:6350 EL SERRANO DR
Practice Address - Street 2:
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63033-8120
Practice Address - Country:US
Practice Address - Phone:314-942-7048
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health