Provider Demographics
NPI:1750956579
Name:MARYMAID
Entity type:Organization
Organization Name:MARYMAID
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAREGIVER
Authorized Official - Prefix:
Authorized Official - First Name:MARY ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-210-6966
Mailing Address - Street 1:605 IRWIN ST
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:CO
Mailing Address - Zip Code:81520-7401
Mailing Address - Country:US
Mailing Address - Phone:970-210-6966
Mailing Address - Fax:
Practice Address - Street 1:605 IRWIN ST
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:CO
Practice Address - Zip Code:81520-7401
Practice Address - Country:US
Practice Address - Phone:970-210-6966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health