Provider Demographics
NPI:1386410017
Name:MERCIFUL MERCY HEALTH GROUP, LLC
Entity type:Organization
Organization Name:MERCIFUL MERCY HEALTH GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED ADESINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-484-9321
Mailing Address - Street 1:4 SHARROW CT
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2624
Mailing Address - Country:US
Mailing Address - Phone:443-323-2081
Mailing Address - Fax:
Practice Address - Street 1:10451 MILL RUN CIR STE 400
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5594
Practice Address - Country:US
Practice Address - Phone:443-323-2081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility