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General NPI Number Information
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NPI Number | 1669028098
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Entity Type | Organization
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Legal Business Name | MCR HEALTH, INC.
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Dates
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Enumeration Date | 08/12/2019
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Last Update Date | 11/28/2023
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Provider Practice Location Address
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Address Line | 725 N 12TH AVE
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City | ARCADIA
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State | FL
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Zip | 34266-8752
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Country | US
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Telephone | 863-494-1242
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Fax | 863-491-0466
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Provider Business Mailing Address
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Address Line | 101 RIVERFRONT BLVD STE 710
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City | BRADENTON
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State | FL
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Zip | 34205-8812
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Country | US
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Telephone | 941-776-4000
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Fax | 941-845-4963
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | MELVIN B PRICE
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Credential |
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Telephone | 941-776-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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