Provider Demographics
NPI:1790341352
Name:MARCEE PROFESSIONAL HOMECARE AGENCY LLC
Entity Type:Organization
Organization Name:MARCEE PROFESSIONAL HOMECARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-574-3059
Mailing Address - Street 1:1186 STRATFORD AVE
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06615-6320
Mailing Address - Country:US
Mailing Address - Phone:203-727-0133
Mailing Address - Fax:
Practice Address - Street 1:1186 STRATFORD AVE
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06615-6320
Practice Address - Country:US
Practice Address - Phone:203-727-0133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-19
Last Update Date:2019-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health