Provider Demographics
NPI:1477881605
Name:MERCIFUL HEARTS HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:MERCIFUL HEARTS HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FAHD
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-408-4622
Mailing Address - Street 1:930 MASON ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2215
Mailing Address - Country:US
Mailing Address - Phone:313-408-4622
Mailing Address - Fax:313-406-7128
Practice Address - Street 1:25121 FORD RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48128-1058
Practice Address - Country:US
Practice Address - Phone:313-408-4622
Practice Address - Fax:313-406-7128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-30
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI239182Medicare Oscar/Certification