Provider Demographics
NPI:1124411103
Name:MERCED HEALTH CARE INC.
Entity Type:Organization
Organization Name:MERCED HEALTH CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:TIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-725-1770
Mailing Address - Street 1:1331 RIVERSIDE CT
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-8409
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:42339 LULANG LN
Practice Address - Street 2:
Practice Address - City:AHWAHNEE
Practice Address - State:CA
Practice Address - Zip Code:93601
Practice Address - Country:US
Practice Address - Phone:209-725-1770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-14
Last Update Date:2015-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities