Provider Demographics
NPI:1972093763
Name:MERCY HOME HEALTHCARE LLC
Entity type:Organization
Organization Name:MERCY HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KHALID
Authorized Official - Middle Name:MOHAMMED
Authorized Official - Last Name:ALZIRKANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-786-2435
Mailing Address - Street 1:1 WESTBROOK CMN STE 2
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092-2874
Mailing Address - Country:US
Mailing Address - Phone:251-786-2435
Mailing Address - Fax:
Practice Address - Street 1:1 WESTBROOK CMN STE 2
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-2874
Practice Address - Country:US
Practice Address - Phone:125-178-6243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-16
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty