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General NPI Number Information
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NPI Number | 1093040388
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Entity Type | Organization
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Legal Business Name | MERCY'S QUALITY HOME CARE, LLC
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Dates
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Enumeration Date | 10/05/2009
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Last Update Date | 12/27/2013
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Provider Practice Location Address
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Address Line | 120 N BERRY ST SUITE 101
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-1093
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Country | US
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Telephone | 678-608-7151
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Fax | 678-289-9256
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Provider Business Mailing Address
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Address Line | 120 N BERRY ST SUITE 101
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-3411
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Country | US
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Telephone | 678-608-7151
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Fax | 678-289-9256
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. MERCY A EKPOUDOM
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Credential | REGISTERED NURSE
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Telephone | 678-608-7151
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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 |
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License Number State |
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