MEDICARE: MERCI'S HOME CORP.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility		FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417967233
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCI'S HOME CORP.

Provider Business Mailing Address
First Line	:	4291 SW 9TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33134-2625
Country	:	US
Telephone Number	:	305-443-8294
Fax Number	:	305-448-3729

Provider Business Practice Location Address
First Line	:	4291 SW 9TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33134-2625
Country	:	US
Telephone Number	:	305-443-8294
Fax Number	:	305-448-3729

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. MYRIAM AGUIAR
Credential	:
Telephone Number	:	305-443-2894

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	08/27/2008

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Directions to “MERCI'S HOME CORP. ” Practice Location

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