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General NPI Number Information
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NPI Number | 1689243438
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Entity Type | Organization
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Legal Business Name | HOUSEOF MERCY ENTERPRISES
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Dates
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Enumeration Date | 06/24/2021
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Last Update Date | 06/24/2021
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Provider Practice Location Address
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Address Line | 1302 W PAYNE ST
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City | OLNEY
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State | TX
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Zip | 76374-1373
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Country | US
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Telephone | 940-564-3339
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Fax |
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Provider Business Mailing Address
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Address Line | 1302 W PAYNE ST
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City | OLNEY
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State | TX
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Zip | 76374-1373
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Country | US
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Telephone | 940-564-3339
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Fax |
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Authorized Official
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Title or Position | ASSISTANT DIRECTOR
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Name | KIMBERLY SMITH
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Credential |
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Telephone | 940-564-3339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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