MEDICARE: MERCE ME CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YP1600X	Pastoral Counselor
2	253Z00000X	In Home Supportive Care Agency
3	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1689209884
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCE ME CARE LLC

Provider Business Mailing Address
First Line	:	2603 BALSAM RIDGE WAY
Second Line	:
City	:	FRESNO
State	:	TX
Zip	:	77545-7210
Country	:	US
Telephone Number	:	719-930-9509
Fax Number	:

Provider Business Practice Location Address
First Line	:	2603 BALSAM RIDGE WAY
Second Line	:
City	:	FRESNO
State	:	TX
Zip	:	77545-7210
Country	:	US
Telephone Number	:	719-930-9509
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. JOHN O MAKINWA
Credential	:	MBA
Telephone Number	:	719-930-9509

Provider Enumeration Date	:	03/08/2020
Last Update Date	:	03/08/2020

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Directions to “MERCE ME CARE LLC ” Practice Location

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