Healthcare Provider Details

I. General information

NPI: 1831170257
Provider Name (Legal Business Name): MERCY RESTORATIVE CARE HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2005
Last Update Date: 01/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 VAIL AVE SEVENTH FLOOR SOUTH
CHARLOTTE NC
28207-1219
US

IV. Provider business mailing address

7800 DALLAS PKWY STE 200
PLANO TX
75024-4082
US

V. Phone/Fax

Practice location:
  • Phone: 704-379-5117
  • Fax: 704-379-6425
Mailing address:
  • Phone: 972-943-1225
  • Fax: 972-943-6401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License NumberH0278
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code284300000X
TaxonomySpecial Hospital
License NumberH0278
License Number StateNC

VIII. Authorized Official

Name: LISA YOUNG
Title or Position: CFO
Credential:
Phone: 972-943-1225