Provider Demographics
NPI:1639879216
Name:MARYS HOME HEALTH CARE AGENCY LLC
Entity Type:Organization
Organization Name:MARYS HOME HEALTH CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:HORTENSE
Authorized Official - Middle Name:
Authorized Official - Last Name:MASSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-206-4435
Mailing Address - Street 1:260 NORTHLAND BLVD STE 213
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-3651
Mailing Address - Country:US
Mailing Address - Phone:513-206-4435
Mailing Address - Fax:
Practice Address - Street 1:260 NORTHLAND BLVD STE 213
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-3651
Practice Address - Country:US
Practice Address - Phone:513-206-4435
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health