Provider Demographics
NPI:1902012370
Name:MARC, INC.
Entity Type:Organization
Organization Name:MARC, INC.
Other - Org Name:MIDLAND ASSOCIATION FOR RETARDED CITIZENS, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-498-8590
Mailing Address - Street 1:2701 NORTH A STREET
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705
Mailing Address - Country:US
Mailing Address - Phone:432-498-8590
Mailing Address - Fax:432-686-2073
Practice Address - Street 1:2701 NORTH A STREET
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705
Practice Address - Country:US
Practice Address - Phone:432-498-8590
Practice Address - Fax:432-686-2073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3984315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000398401Medicaid