Provider Demographics
NPI:1942861570
Name:MARIE'S FAMILY HEALTHCARE & SITTER SERVICE INC
Entity Type:Organization
Organization Name:MARIE'S FAMILY HEALTHCARE & SITTER SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MATILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-574-9009
Mailing Address - Street 1:PO BOX 1404
Mailing Address - Street 2:
Mailing Address - City:TALLULAH
Mailing Address - State:LA
Mailing Address - Zip Code:71284-1404
Mailing Address - Country:US
Mailing Address - Phone:318-574-9009
Mailing Address - Fax:318-574-9926
Practice Address - Street 1:402 E CRAIG ST
Practice Address - Street 2:
Practice Address - City:TALLULAH
Practice Address - State:LA
Practice Address - Zip Code:71282-3718
Practice Address - Country:US
Practice Address - Phone:318-574-9009
Practice Address - Fax:318-574-9926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1127159Medicaid