Provider Demographics
NPI:1598750358
Name:MARQUIS COMPANIES I INC
Entity Type:Organization
Organization Name:MARQUIS COMPANIES I INC
Other - Org Name:MARQUIS CARE AT SHASTA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE CONTROLLLER
Authorized Official - Prefix:MS
Authorized Official - First Name:STACI
Authorized Official - Middle Name:
Authorized Official - Last Name:TONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-222-3630
Mailing Address - Street 1:3550 CHURN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-2718
Mailing Address - Country:US
Mailing Address - Phone:530-222-3630
Mailing Address - Fax:530-222-3638
Practice Address - Street 1:3550 CHURN CREEK RD
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-2718
Practice Address - Country:US
Practice Address - Phone:530-222-3630
Practice Address - Fax:530-222-3638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-16
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA230000033314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZR06222GMedicaid
CA056222Medicare Oscar/Certification