# MARY AGNES HOME CARE SERVICE, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811152457
- **Authorized official:** MRS. DEBRA COOK (OWNER)
- **Authorized official phone:** (757) 595-3334

## Contact information

- **Practice address:** 12388 WARWICK BLVD STE 301E, NEWPORT NEWS, VA 23606-3857
- **Practice address phone:** (757) 595-3334
- **Practice address fax:** (757) 595-3866
- **Mailing address:** 12388 WARWICK BLVD STE 301E, NEWPORT NEWS, VA 23606-3857
- **Mailing address phone:** (757) 595-3334
- **Mailing address fax:** (757) 595-3866

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 8821782008 | VA | Yes |

## Other

- **Enumeration date:** 07/23/2008
- **Last updated:** 07/23/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0103954456 | — | VA |