Provider Demographics
NPI:1073920831
Name:DIVINE MERCY HIGH QUALITY NURSING AGENCY INC
Entity Type:Organization
Organization Name:DIVINE MERCY HIGH QUALITY NURSING AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:AFOMA
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-556-6410
Mailing Address - Street 1:3706 GREEN ASH CT
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3826
Mailing Address - Country:US
Mailing Address - Phone:301-556-6410
Mailing Address - Fax:
Practice Address - Street 1:3706 GREEN ASH CT
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-3826
Practice Address - Country:US
Practice Address - Phone:301-556-6410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-14
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDNS9912011251E00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care