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General NPI Number Information
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NPI Number | 1114056249
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Entity Type | Organization
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Legal Business Name | MARSHALL MANOR HOMECARE, LLC
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 2905 S WASHINGTON AVE
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City | MARSHALL
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State | TX
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Zip | 75672-7769
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Country | US
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Telephone | 903-923-8154
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Fax | 903-923-8624
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Provider Business Mailing Address
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Address Line | 2905 S WASHINGTON AVE
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City | MARSHALL
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State | TX
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Zip | 75672-7769
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Country | US
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Telephone | 903-923-8154
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Fax | 903-923-8624
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Authorized Official
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Title or Position | OWNER
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Name | MR. BRANDON WHITE
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Credential |
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Telephone | 903-923-8154
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 009761
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License Number State | TX
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