Provider Demographics
NPI:1760225155
Name:MARY'S HEART HOME CARE SERVICE
Entity type:Organization
Organization Name:MARY'S HEART HOME CARE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER, CEO
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-564-5124
Mailing Address - Street 1:1380 HASLETT RD STE 16
Mailing Address - Street 2:
Mailing Address - City:HASLETT
Mailing Address - State:MI
Mailing Address - Zip Code:48840-7623
Mailing Address - Country:US
Mailing Address - Phone:888-329-7790
Mailing Address - Fax:
Practice Address - Street 1:1380 HASLETT RD STE 16
Practice Address - Street 2:
Practice Address - City:HASLETT
Practice Address - State:MI
Practice Address - Zip Code:48840-7623
Practice Address - Country:US
Practice Address - Phone:810-564-5124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-14
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care