Provider Demographics
NPI:1356952329
Name:MARY LOUISE HEALTH & HOME CARE SERVICES, LLC
Entity type:Organization
Organization Name:MARY LOUISE HEALTH & HOME CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:ALVON
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-597-9956
Mailing Address - Street 1:600 PARK OFFICES DRIVE SUITE 300
Mailing Address - Street 2:600 PARK OFFICES DRIVE SUITE 300
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27709
Mailing Address - Country:US
Mailing Address - Phone:919-597-9956
Mailing Address - Fax:
Practice Address - Street 1:600 PARK OFFICES DRIVE SUITE 300
Practice Address - Street 2:600 PARK OFFICES DRIVE SUITE 300
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27709
Practice Address - Country:US
Practice Address - Phone:919-597-9956
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care