Healthcare Provider Details

I. General information

NPI: 1689209884
Provider Name (Legal Business Name): MERCE ME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2020
Last Update Date: 03/08/2020
Certification Date: 03/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2603 BALSAM RIDGE WAY
FRESNO TX
77545-7210
US

IV. Provider business mailing address

2603 BALSAM RIDGE WAY
FRESNO TX
77545-7210
US

V. Phone/Fax

Practice location:
  • Phone: 719-930-9509
  • Fax:
Mailing address:
  • Phone: 719-930-9509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN O MAKINWA
Title or Position: ADMINISTRATOR
Credential: MBA
Phone: 719-930-9509