Provider Demographics
NPI:1700764594
Name:MARYS LOVE LLC
Entity type:Organization
Organization Name:MARYS LOVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TOYA
Authorized Official - Middle Name:T
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-782-2228
Mailing Address - Street 1:19954 AVON AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-1557
Mailing Address - Country:US
Mailing Address - Phone:313-782-2228
Mailing Address - Fax:
Practice Address - Street 1:19954 AVON AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-1557
Practice Address - Country:US
Practice Address - Phone:313-782-2228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health