Provider Demographics
NPI:1821561341
Name:AMERICARE TEXAS
Entity Type:Organization
Organization Name:AMERICARE TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MYSTI
Authorized Official - Middle Name:MAREE
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-704-6087
Mailing Address - Street 1:PO BOX 1516
Mailing Address - Street 2:
Mailing Address - City:LA VERNIA
Mailing Address - State:TX
Mailing Address - Zip Code:78121-1500
Mailing Address - Country:US
Mailing Address - Phone:318-704-6087
Mailing Address - Fax:318-704-6089
Practice Address - Street 1:105 MULBERRY
Practice Address - Street 2:
Practice Address - City:LA VERNIA
Practice Address - State:TX
Practice Address - Zip Code:78121-4637
Practice Address - Country:US
Practice Address - Phone:318-704-6087
Practice Address - Fax:318-704-6089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care