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General NPI Number Information
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NPI Number | 1033701990
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Entity Type | Organization
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Legal Business Name | MERCY BOARD AND CARE INC
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Dates
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Enumeration Date | 02/10/2021
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Last Update Date | 02/10/2021
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Provider Practice Location Address
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Address Line | 11545 DOVERWOOD DR
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City | RIVERSIDE
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State | CA
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Zip | 92505-4831
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Country | US
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Telephone | 951-847-8543
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Fax | 515-473-3653
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Provider Business Mailing Address
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Address Line | 11545 DOVERWOOD DR
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City | RIVERSIDE
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State | CA
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Zip | 92505-4831
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Country | US
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Telephone | 951-847-8543
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Fax | 515-473-3653
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MAHER M ISMAIL
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Credential |
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Telephone | 951-847-8543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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