Provider Demographics
NPI:1689110140
Name:MMCARE LLC
Entity Type:Organization
Organization Name:MMCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:BOOTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-383-1045
Mailing Address - Street 1:137 FRENCH PLACE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212
Mailing Address - Country:US
Mailing Address - Phone:210-734-1300
Mailing Address - Fax:210-734-1301
Practice Address - Street 1:602 BABCOCK RD STE 100
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-3101
Practice Address - Country:US
Practice Address - Phone:210-734-1300
Practice Address - Fax:210-734-1301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-09
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010035251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health