Provider Demographics
NPI:1316025687
Name:MARIE CARES, LLC
Entity Type:Organization
Organization Name:MARIE CARES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MYRTIS
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-497-4861
Mailing Address - Street 1:231 MASON BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39212-5035
Mailing Address - Country:US
Mailing Address - Phone:601-497-4861
Mailing Address - Fax:601-373-3716
Practice Address - Street 1:231 MASON BLVD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39212-5035
Practice Address - Country:US
Practice Address - Phone:601-497-4861
Practice Address - Fax:601-373-3716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSP314106251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS07905217Medicaid