Provider Demographics
NPI:1518423276
Name:MARY K HOME HEALTH CARE
Entity Type:Organization
Organization Name:MARY K HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOURE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-335-7145
Mailing Address - Street 1:43245 STONEWALL POND ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH RIDING
Mailing Address - State:VA
Mailing Address - Zip Code:20152-4427
Mailing Address - Country:US
Mailing Address - Phone:571-335-7145
Mailing Address - Fax:
Practice Address - Street 1:43245 STONEWALL POND ST
Practice Address - Street 2:
Practice Address - City:SOUTH RIDING
Practice Address - State:VA
Practice Address - Zip Code:20152-4427
Practice Address - Country:US
Practice Address - Phone:571-335-7145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-18
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty