Provider Demographics
NPI:1689949240
Name:LOVE MARCS
Entity Type:Organization
Organization Name:LOVE MARCS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER, OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:FREDGENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-952-4723
Mailing Address - Street 1:4041 W WHEATLAND RD
Mailing Address - Street 2:STE. 156-352
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-4063
Mailing Address - Country:US
Mailing Address - Phone:469-952-4723
Mailing Address - Fax:
Practice Address - Street 1:810 HILLSIDE DR
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-4707
Practice Address - Country:US
Practice Address - Phone:469-952-4723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-15
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child