Organization
MACKNIFICENT CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYAH S MACK (OWNER)
(414) 509-4661
Entity
Organization
Contact information
Practice address
5019 W NORTH AVE STE 108, MILWAUKEE, WI 53208-1121
(414) 509-4661
Mailing address
1702 W CENTER ST, MILWAUKEE, WI 53206-2106
(414) 509-4661
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
10/16/2023
Last updated
10/16/2023
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