Provider Demographics
NPI:1346975430
Name:MECARE HOME HEALTH CARE AGENCY, LLC
Entity Type:Organization
Organization Name:MECARE HOME HEALTH CARE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BERTHA
Authorized Official - Middle Name:O
Authorized Official - Last Name:NKEMERE
Authorized Official - Suffix:
Authorized Official - Credentials:NP, RN
Authorized Official - Phone:442-271-9670
Mailing Address - Street 1:PO BOX 3431
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91729-3431
Mailing Address - Country:US
Mailing Address - Phone:442-271-9670
Mailing Address - Fax:
Practice Address - Street 1:11030 ARROW RTE
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-4836
Practice Address - Country:US
Practice Address - Phone:442-271-9670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health