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General NPI Number Information
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NPI Number | 1225029366
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Entity Type | Organization
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Legal Business Name | MERCY RETIREMENT AND CARE CENTER
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Dates
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Enumeration Date | 10/28/2005
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 3431 FOOTHILL BLVD
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City | OAKLAND
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State | CA
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Zip | 94601-3129
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Country | US
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Telephone | 510-534-8540
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Fax | 510-261-4516
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Provider Business Mailing Address
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Address Line | 3431 FOOTHILL BLVD
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City | OAKLAND
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State | CA
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Zip | 94601-3129
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Country | US
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Telephone | 510-534-8540
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Fax | 510-261-4516
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Authorized Official
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Title or Position | CEO
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Name | MS. ADRIENE IVERSON
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Credential |
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Telephone | 510-769-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 020000237
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License Number State | CA
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