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General NPI Number Information
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NPI Number | 1255838967
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Entity Type | Organization
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Legal Business Name | LADY OF MERCY HOME CARE
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Dates
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Enumeration Date | 04/09/2018
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Last Update Date | 04/09/2018
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Provider Practice Location Address
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Address Line | 2222 OLIVE RD
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City | DAYTON
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State | OH
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Zip | 45426-2604
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Country | US
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Telephone | 937-546-4590
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Fax |
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Provider Business Mailing Address
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Address Line | 2222 OLIVE RD
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City | DAYTON
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State | OH
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Zip | 45426-2604
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Country | US
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Telephone | 937-546-4590
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Fax | 937-854-0505
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Authorized Official
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Title or Position | OWNER
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Name | MUSTAFA HUSSEIN
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Credential |
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Telephone | 937-546-4590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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