MEDICARE: MERCY HOME HEALTH CARE SERVICES, INC.

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1568116275
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCY HOME HEALTH CARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	14545 FRIAR ST STE 222
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91411-4719
Country	:	US
Telephone Number	:	818-821-4108
Fax Number	:	888-522-6417

Provider Business Practice Location Address
First Line	:	14545 FRIAR ST STE 222
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91411-4719
Country	:	US
Telephone Number	:	818-821-4108
Fax Number	:	888-522-6417

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MISS SONA MINASIAN
Credential	:
Telephone Number	:	818-821-4108

Provider Enumeration Date	:	02/10/2022
Last Update Date	:	02/10/2022

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