Provider Demographics
NPI:1659436921
Name:MARI HOME HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:MARI HOME HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JANEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMARRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-283-5940
Mailing Address - Street 1:21141 GOVERNORS HWY
Mailing Address - Street 2:STE# 208
Mailing Address - City:MATTESON
Mailing Address - State:IL
Mailing Address - Zip Code:60443-3801
Mailing Address - Country:US
Mailing Address - Phone:708-283-5940
Mailing Address - Fax:708-283-5941
Practice Address - Street 1:21141 GOVERNORS HWY
Practice Address - Street 2:STE# 208
Practice Address - City:MATTESON
Practice Address - State:IL
Practice Address - Zip Code:60443-3801
Practice Address - Country:US
Practice Address - Phone:708-283-5940
Practice Address - Fax:708-283-5941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010581251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL460782OtherTHE JOINT COMMISSION
IL14-7996Medicare PIN