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General NPI Number Information
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NPI Number | 1386410017
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Entity Type | Organization
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Legal Business Name | MERCIFUL MERCY HEALTH GROUP, LLC
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Dates
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Enumeration Date | 12/04/2023
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Last Update Date | 12/04/2023
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Provider Practice Location Address
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Address Line | 10451 MILL RUN CIR STE 400
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City | OWINGS MILLS
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State | MD
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Zip | 21117-5594
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Country | US
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Telephone | 443-323-2081
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Fax |
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Provider Business Mailing Address
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Address Line | 4 SHARROW CT
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City | WINDSOR MILL
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State | MD
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Zip | 21244-2624
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Country | US
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Telephone | 443-323-2081
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | VICTORIA AHMED ADESINA
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Credential |
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Telephone | 240-484-9321
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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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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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Taxonomy #4
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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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