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General NPI Number Information
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NPI Number | 1154317048
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Entity Type | Organization
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Legal Business Name | MERCY COMMUNITY HOMECARE SERVICES, INC
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Dates
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Enumeration Date | 09/26/2005
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Last Update Date | 06/17/2010
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Provider Practice Location Address
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Address Line | 2021 ALBANY AVENUE
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City | WEST HARTFORD
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State | CT
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Zip | 06117
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Country | US
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Telephone | 860-586-8318
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Fax | 860-586-8418
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Provider Business Mailing Address
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Address Line | 275 STEELE ROAD
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City | WEST HARTFORD
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State | CT
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Zip | 06117-2755
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Country | US
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Telephone | 860-586-8318
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Fax | 860-586-8418
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Authorized Official
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Title or Position | TREASURER
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Name | STEVEN D BEAULIEU
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Credential | CPA
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Telephone | 860-570-8304
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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 | C9815005
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License Number State | CT
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