Provider Demographics
NPI:1831914878
Name:MERCY HOME HEALTH LLC
Entity type:Organization
Organization Name:MERCY HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMAL
Authorized Official - Middle Name:S
Authorized Official - Last Name:DIRIE
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:608-977-3566
Mailing Address - Street 1:4857 LACY RD
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53711-5758
Mailing Address - Country:US
Mailing Address - Phone:608-977-3566
Mailing Address - Fax:
Practice Address - Street 1:4857 LACY RD
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711-5758
Practice Address - Country:US
Practice Address - Phone:608-977-3566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health