Provider Demographics
NPI:1407033517
Name:MERCY HOME CARE, INC
Entity Type:Organization
Organization Name:MERCY HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-338-1141
Mailing Address - Street 1:800 COOPER ST
Mailing Address - Street 2:SUITE 525
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08102-1155
Mailing Address - Country:US
Mailing Address - Phone:856-338-1141
Mailing Address - Fax:856-338-1151
Practice Address - Street 1:800 COOPER ST
Practice Address - Street 2:SUITE 525
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08102-1155
Practice Address - Country:US
Practice Address - Phone:856-338-1141
Practice Address - Fax:856-338-1151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0250100251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0147851Medicaid