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General NPI Number Information
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NPI Number | 1154775039
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Entity Type | Organization
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Legal Business Name | LAS MERCEDES ADULT DAY CARE V, LLC
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Dates
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Enumeration Date | 04/18/2016
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 11930 NW 87TH CT
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City | HIALEAH GARDENS
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State | FL
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Zip | 33018-1912
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Country | US
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Telephone | 786-533-0140
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Fax |
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Provider Business Mailing Address
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Address Line | 11930 NW 87TH CT
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City | HIALEAH GARDENS
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State | FL
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Zip | 33018-1912
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Country | US
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Telephone | 786-533-0140
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | JORGE RAAD
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Credential |
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Telephone | 786-233-6981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 9346
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License Number State | FL
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