Provider Demographics
NPI:1932705464
Name:LAS MERCEDES ADULT DAY CARE IV, INC.
Entity Type:Organization
Organization Name:LAS MERCEDES ADULT DAY CARE IV, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CLARA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-533-0141
Mailing Address - Street 1:91 W 21ST ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-2613
Mailing Address - Country:US
Mailing Address - Phone:786-533-0141
Mailing Address - Fax:786-219-4267
Practice Address - Street 1:91 W 21ST ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-2613
Practice Address - Country:US
Practice Address - Phone:786-533-0141
Practice Address - Fax:786-219-4267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care