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General NPI Number Information
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NPI Number | 1053757658
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Entity Type | Organization
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Legal Business Name | HANDS OF MERCY
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Dates
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Enumeration Date | 05/22/2013
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Last Update Date | 05/22/2013
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Provider Practice Location Address
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Address Line | 1400 GRAY HWY
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City | MACON
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State | GA
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Zip | 31211-1901
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Country | US
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Telephone | 478-978-6507
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Fax | 478-978-6508
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Provider Business Mailing Address
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Address Line | 1400 GRAY HWY
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City | MACON
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State | GA
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Zip | 31211-1901
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Country | US
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Telephone | 478-978-6507
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Fax | 478-978-6508
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Authorized Official
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Title or Position | SELF EMPLOYED CONTRACTOR
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Name | MRS. DIANNE C. RHYNES
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Credential |
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Telephone | 478-978-6507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | CN0011744692
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License Number State | GA
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