Provider Demographics
NPI:1699574632
Name:MEDMARIE & FAMILY HOMECARE LLC
Entity type:Organization
Organization Name:MEDMARIE & FAMILY HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:JILO
Authorized Official - Last Name:BAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-216-7825
Mailing Address - Street 1:10615 NE 25TH PL
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98686-4708
Mailing Address - Country:US
Mailing Address - Phone:720-216-7825
Mailing Address - Fax:360-828-5926
Practice Address - Street 1:10615 NE 25TH PL
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98686-4708
Practice Address - Country:US
Practice Address - Phone:720-216-7825
Practice Address - Fax:360-828-5926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home