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General NPI Number Information
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NPI Number | 1932705464
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Entity Type | Organization
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Legal Business Name | LAS MERCEDES ADULT DAY CARE IV, INC.
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Dates
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Enumeration Date | 12/09/2020
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Last Update Date | 12/09/2020
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Provider Practice Location Address
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Address Line | 91 W 21ST ST
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City | HIALEAH
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State | FL
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Zip | 33010-2613
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Country | US
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Telephone | 786-533-0141
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Fax | 786-219-4267
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Provider Business Mailing Address
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Address Line | 91 W 21ST ST
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City | HIALEAH
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State | FL
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Zip | 33010-2613
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Country | US
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Telephone | 786-533-0141
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Fax | 786-219-4267
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CLARA RIVAS
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Credential |
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Telephone | 786-533-0141
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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 |
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License Number State |
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