Provider Demographics
NPI:1013348721
Name:COUNTY OF MERCED
Entity Type:Organization
Organization Name:COUNTY OF MERCED
Other - Org Name:MULTIPURPOSE SENIOR SERVICES PROGRAM (MSSP)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF HUMAN SERVICES AGENCY
Authorized Official - Prefix:
Authorized Official - First Name:YVONNIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-385-3000
Mailing Address - Street 1:PO BOX 112
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95341-0112
Mailing Address - Country:US
Mailing Address - Phone:209-722-1738
Mailing Address - Fax:209-725-3836
Practice Address - Street 1:2115 WARDROBE AVE
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95341-6445
Practice Address - Country:US
Practice Address - Phone:209-385-3105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-05
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMSS00028FMedicare PIN