Organization
MARY AGNES HOME CARE SERVICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA COOK (OWNER)
(757) 595-3334
Entity
Organization
Contact information
Practice address
12388 WARWICK BLVD STE 301E, NEWPORT NEWS, VA 23606-3857
(757) 595-3334
(757) 595-3866
Mailing address
12388 WARWICK BLVD STE 301E, NEWPORT NEWS, VA 23606-3857
(757) 595-3334
(757) 595-3866
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
8821782008
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0103954456
—
VA
Enumeration date
07/23/2008
Last updated
07/23/2008
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