Provider Demographics
NPI:1518570878
Name:MACKS HOME CARE LLC
Entity Type:Organization
Organization Name:MACKS HOME CARE LLC
Other - Org Name:MACKS HOME CARE LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGIN MBR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCBETH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-481-4695
Mailing Address - Street 1:539 W COMMERCE ST STE 4959
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-1953
Mailing Address - Country:US
Mailing Address - Phone:312-481-4695
Mailing Address - Fax:
Practice Address - Street 1:11 TEMPLE LN
Practice Address - Street 2:
Practice Address - City:NEW WAVERLY
Practice Address - State:TX
Practice Address - Zip Code:77358
Practice Address - Country:US
Practice Address - Phone:312-481-4695
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-26
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker