=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538436654
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GRACE & MERCY ELDERLY CARE, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/17/2011
-----------------------------------------------------
Last Update Date | 05/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2506 MOUNT MORIAH RD STE B459
-----------------------------------------------------
City | MEMPHIS
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38115-1511
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 901-649-0844
-----------------------------------------------------
Fax | 662-932-8300
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5732 WOODBOURNE COURT
-----------------------------------------------------
City | MEMPHIS
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38115-6114
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 901-649-0844
-----------------------------------------------------
Fax | 901-363-8869
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | TONYA DIXON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 901-649-0844
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------