Provider Demographics
NPI:1407447253
Name:GRACE AND MERCY HOME HEALTH CARE LLC.
Entity Type:Organization
Organization Name:GRACE AND MERCY HOME HEALTH CARE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAIWANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMERALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-425-8201
Mailing Address - Street 1:6575 ANNA MAY DR
Mailing Address - Street 2:
Mailing Address - City:WALLS
Mailing Address - State:MS
Mailing Address - Zip Code:38680-9214
Mailing Address - Country:US
Mailing Address - Phone:901-425-8201
Mailing Address - Fax:
Practice Address - Street 1:6575 ANNA MAY DR
Practice Address - Street 2:
Practice Address - City:WALLS
Practice Address - State:MS
Practice Address - Zip Code:38680-9214
Practice Address - Country:US
Practice Address - Phone:901-425-8201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No251E00000XAgenciesHome Health