Healthcare Provider Details

I. General information

NPI: 1073920831
Provider Name (Legal Business Name): DIVINE MERCY HIGH QUALITY NURSING AGENCY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2014
Last Update Date: 07/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3706 GREEN ASH CT
BELTSVILLE MD
20705-3826
US

IV. Provider business mailing address

3706 GREEN ASH CT
BELTSVILLE MD
20705-3826
US

V. Phone/Fax

Practice location:
  • Phone: 301-556-6410
  • Fax:
Mailing address:
  • Phone: 301-556-6410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberNS9912011
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberNS9912011
License Number StateMD

VIII. Authorized Official

Name: MRS. GRACE AFOMA ABRAHAM
Title or Position: PRESIDENT
Credential:
Phone: 301-556-6410