Provider Demographics
NPI:1780915868
Name:MERCY HEALTH SERVICES
Entity type:Organization
Organization Name:MERCY HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADNIMISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JALLOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-717-9836
Mailing Address - Street 1:52 JOYCETON WAY
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1400
Mailing Address - Country:US
Mailing Address - Phone:240-602-1995
Mailing Address - Fax:301-333-4779
Practice Address - Street 1:52 JOYCETON WAY
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-1400
Practice Address - Country:US
Practice Address - Phone:240-602-1995
Practice Address - Fax:301-333-4779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-28
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2858R251E00000X
251E00000X, 253Z00000X, 376J00000X, 385H00000X, 372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty