Healthcare Provider Details
I. General information
NPI: 1811829021
Provider Name (Legal Business Name): GRACE & MERCY COMMUNITY SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4414 LAVENDER LN
BOWIE MD
20720-4265
US
IV. Provider business mailing address
4601 PRESIDENTS DR STE 232
LANHAM MD
20706-4870
US
V. Phone/Fax
- Phone: 301-441-2368
- Fax: 301-441-2360
- Phone: 301-441-2368
- Fax: 301-441-2360
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MERCY
FORLU
Title or Position: CEO
Credential: PHD, MA, BA, RN
Phone: 301-441-2368