Provider Demographics
NPI: | 1669028098 |
---|---|
Name: | MCR HEALTH, INC. |
Entity type: | Organization |
Organization Name: | MCR HEALTH, INC. |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT & CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MELVIN |
Authorized Official - Middle Name: | B |
Authorized Official - Last Name: | PRICE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 941-776-4000 |
Mailing Address - Street 1: | 101 RIVERFRONT BLVD STE 710 |
Mailing Address - Street 2: | |
Mailing Address - City: | BRADENTON |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 34205-8812 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 941-776-4000 |
Mailing Address - Fax: | 941-845-4963 |
Practice Address - Street 1: | 725 N 12TH AVE |
Practice Address - Street 2: | |
Practice Address - City: | ARCADIA |
Practice Address - State: | FL |
Practice Address - Zip Code: | 34266-8752 |
Practice Address - Country: | US |
Practice Address - Phone: | 863-494-1242 |
Practice Address - Fax: | 863-491-0466 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-08-12 |
Last Update Date: | 2023-11-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251S00000X | Agencies | Community/Behavioral Health | |
No | 261QF0400X | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |