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NPI Code Detail

MEDICARE: MERCYGRACE HEALTHCARE, INC.

MEDICARE: MERCYGRACE HEALTHCARE, 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
1251E00000XHome Health Agency008547TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932195591
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERCYGRACE HEALTHCARE, INC.
Provider Business Mailing Address
First Line : 12959 JUPITER RD
Second Line : SUITE 140
City : DALLAS
State : TX
Zip : 75238-3200
Country : US
Telephone Number : 214-221-8585
Fax Number : 214-221-8586
Provider Business Practice Location Address
First Line : 12959 JUPITER ROAD
Second Line : SUITE 140
City : DALLAS
State : TX
Zip : 75238-3200
Country : US
Telephone Number : 214-221-8585
Fax Number : 214-221-8586
Authorized Official
Title or Position : ADMINISTRATOR/CEO
Name : MS. MERCY C QUACHIE
Credential : BSC, LNFA
Telephone Number : 214-221-8585
Provider Enumeration Date : 09/20/2005
Last Update Date : 06/02/2009

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Directions to “MERCYGRACE HEALTHCARE, INC. ” Practice Location

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