Provider Demographics
NPI:1447145719
Name:MERCYLAND RESIDENTIAL
Entity type:Organization
Organization Name:MERCYLAND RESIDENTIAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LILY
Authorized Official - Middle Name:
Authorized Official - Last Name:OSEI
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:616-389-3701
Mailing Address - Street 1:1296 REGENT DR
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-2064
Mailing Address - Country:US
Mailing Address - Phone:616-389-3701
Mailing Address - Fax:
Practice Address - Street 1:1296 REGENT DR
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-2064
Practice Address - Country:US
Practice Address - Phone:616-389-3701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness