Provider Demographics
NPI:1073742326
Name:ACCESSCARE HOME OF MERCED
Entity Type:Organization
Organization Name:ACCESSCARE HOME OF MERCED
Other - Org Name:LMC
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:AYROSO
Authorized Official - Last Name:MUNSAYAC
Authorized Official - Suffix:
Authorized Official - Credentials:BACHELORS DEGREE
Authorized Official - Phone:209-722-2080
Mailing Address - Street 1:128 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-5047
Mailing Address - Country:US
Mailing Address - Phone:209-233-9740
Mailing Address - Fax:
Practice Address - Street 1:128 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-5047
Practice Address - Country:US
Practice Address - Phone:209-233-9740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA247203977310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility