Provider Demographics
NPI:1760924815
Name:MERCY AND GRACE HOME HEALTH CARE AND HOSPICE SERVICES LLC
Entity Type:Organization
Organization Name:MERCY AND GRACE HOME HEALTH CARE AND HOSPICE SERVICES LLC
Other - Org Name:MERCY AND GRACE HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LINGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-388-0073
Mailing Address - Street 1:1516 OAK ST STE 109
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-2953
Mailing Address - Country:US
Mailing Address - Phone:510-388-0073
Mailing Address - Fax:510-217-3644
Practice Address - Street 1:1516 OAK ST STE 109
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-2953
Practice Address - Country:US
Practice Address - Phone:510-388-0073
Practice Address - Fax:510-217-3644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health