Provider Demographics
NPI:1275023756
Name:MAYS HOUSECALL HOME HEALTH OF SOUTH EAST OK, LLC
Entity Type:Organization
Organization Name:MAYS HOUSECALL HOME HEALTH OF SOUTH EAST OK, LLC
Other - Org Name:MAYS HOME CARE IDABEL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:K
Authorized Official - Last Name:DRENNEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-905-4810
Mailing Address - Street 1:3310 LAMAR AVE STE A
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-5024
Mailing Address - Country:US
Mailing Address - Phone:903-905-4810
Mailing Address - Fax:
Practice Address - Street 1:2101 SE WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:IDABEL
Practice Address - State:OK
Practice Address - Zip Code:74745-5455
Practice Address - Country:US
Practice Address - Phone:580-286-5426
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-10
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK7071OtherSTATE OF OKLAHOMA