Provider Demographics
NPI:1275249534
Name:MCCORMICK ENTERPRISE LLC
Entity Type:Organization
Organization Name:MCCORMICK ENTERPRISE LLC
Other - Org Name:ACTI-KARE RESPONSIVE IN HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORENA
Authorized Official - Middle Name:LISSET
Authorized Official - Last Name:UBILLUS ALARCON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-381-2482
Mailing Address - Street 1:10649 MCCORMICK FARM DR.
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110
Mailing Address - Country:US
Mailing Address - Phone:240-381-2482
Mailing Address - Fax:
Practice Address - Street 1:10432 BALLS FORD RD STE 300
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-2517
Practice Address - Country:US
Practice Address - Phone:240-381-2482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health