MEDICARE: MERCY BIDEMI ARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3104A0630X	Assisted Living Facility (Behavioral Disturbances)

General Provider Information

NPI Number	:	1508511601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERCY BIDEMI ARE

Provider Business Mailing Address
First Line	:	1701 COUNTRYWOOD CT
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20785-4008
Country	:	US
Telephone Number	:	240-772-4140
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 COUNTRYWOOD CT
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20785-4008
Country	:	US
Telephone Number	:	240-772-4140
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2022
Last Update Date	:	02/16/2022

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Directions to “ MERCY BIDEMI ARE ” Practice Location

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