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General NPI Number Information
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NPI Number | 1528403326
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Entity Type | Organization
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Legal Business Name | MARCED, INC
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Dates
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Enumeration Date | 05/07/2013
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Last Update Date | 05/07/2013
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Provider Practice Location Address
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Address Line | 1645 BARTLETT AVE
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City | ORANGE PARK
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State | FL
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Zip | 32073-3616
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Country | US
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Telephone | 904-264-9570
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Fax | 904-264-9570
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Provider Business Mailing Address
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Address Line | 1645 BARTLETT AVE
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City | ORANGE PARK
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State | FL
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Zip | 32073-3616
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Country | US
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Telephone | 904-264-9570
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Fax | 904-264-9570
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAULINE DYER
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Credential |
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Telephone | 904-708-8471
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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 | AL8379
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License Number State | FL
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