MEDICARE: GRACE & MERCY COMMUNITY 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	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1811829021
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACE & MERCY COMMUNITY SERVICES INC.

Provider Business Mailing Address
First Line	:	4601 PRESIDENTS DR STE 232
Second Line	:
City	:	LANHAM
State	:	MD
Zip	:	20706-4870
Country	:	US
Telephone Number	:	301-441-2368
Fax Number	:	301-441-2360

Provider Business Practice Location Address
First Line	:	4414 LAVENDER LN
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20720-4265
Country	:	US
Telephone Number	:	301-441-2368
Fax Number	:	301-441-2360

Authorized Official
Title or Position	:	CEO
Name	:	MERCY FORLU
Credential	:	PHD, MA, BA, RN
Telephone Number	:	301-441-2368

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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