Provider Demographics
NPI:1427385038
Name:MARYS ADULT FAMILY SERVICES LLC
Entity Type:Organization
Organization Name:MARYS ADULT FAMILY SERVICES LLC
Other - Org Name:MAFHS, LLC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSING DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MROZINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:262-327-2219
Mailing Address - Street 1:2802 N 40TH ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210-1806
Mailing Address - Country:US
Mailing Address - Phone:920-574-6672
Mailing Address - Fax:
Practice Address - Street 1:2802 N 40TH ST
Practice Address - Street 2:SUITE 210
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53210-1806
Practice Address - Country:US
Practice Address - Phone:920-574-6672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-03
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIDSL-2426314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility