Healthcare Provider Details

I. General information

NPI: 1316011851
Provider Name (Legal Business Name): MERRITT MANOR, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 E MERRITT AVE
TULARE CA
93274-2135
US

IV. Provider business mailing address

604 E MERRITT AVE
TULARE CA
93274-2135
US

V. Phone/Fax

Practice location:
  • Phone: 559-686-1601
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number120000583
License Number StateCA

VIII. Authorized Official

Name: JAMES HIGBEE
Title or Position: CFO
Credential:
Phone: 559-688-0288