Provider Demographics
NPI:1275075921
Name:MARY'S HOME HEALTH CARE AGENCY LLC
Entity Type:Organization
Organization Name:MARY'S HOME HEALTH CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-708-8711
Mailing Address - Street 1:11126 E PARKS RD
Mailing Address - Street 2:
Mailing Address - City:WHEELER
Mailing Address - State:MI
Mailing Address - Zip Code:48662-9789
Mailing Address - Country:US
Mailing Address - Phone:989-708-8711
Mailing Address - Fax:989-842-1765
Practice Address - Street 1:11126 E PARKS RD
Practice Address - Street 2:
Practice Address - City:WHEELER
Practice Address - State:MI
Practice Address - Zip Code:48662-9789
Practice Address - Country:US
Practice Address - Phone:989-708-8711
Practice Address - Fax:989-842-1765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-11
Last Update Date:2016-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2355310990251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health