Provider Demographics
NPI:1639720832
Name:MERCIFUL HEAVENLY HOMES
Entity Type:Organization
Organization Name:MERCIFUL HEAVENLY HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:CRAWFORD
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-287-8864
Mailing Address - Street 1:PO BOX 106
Mailing Address - Street 2:
Mailing Address - City:SUNBURY
Mailing Address - State:NC
Mailing Address - Zip Code:27979-0106
Mailing Address - Country:US
Mailing Address - Phone:252-287-8864
Mailing Address - Fax:
Practice Address - Street 1:279 TUGGIE EURE RD
Practice Address - Street 2:
Practice Address - City:EURE
Practice Address - State:NC
Practice Address - Zip Code:27935-9683
Practice Address - Country:US
Practice Address - Phone:252-287-8864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-28
Last Update Date:2019-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home