MERCYS SUPPORTIVE LIVING (NPI# 1124418595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124418595 |
| Entity Type | Organization |
| Organization Name | MERCYS SUPPORTIVE LIVING |
| Practice Address |
932 Cobble Ridge Rd Nashville NC 27856-7868 |
| Practice Telephone | 2524436811 |
| Practice Fax Number | 2524436811 |
| Mailing Telephone | 2524436811 |
| Mailing Fax Number | 2524436811 |
| Enumeration Date | 2015-01-23 |
| Last Update Date | 2015-03-04 |
| Authorized Official Name | ISAAC CONRAD BRAKE (ADMINISTRATOR) |
| Authorized Official Telephone | 2524436811 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
FCL064-027 | NC | Nursing & Custodial Care Facilities |
| Street Address |
932 COBBLE RIDGE RD |
| City | NASHVILLE |
| State | NC |
| Zip Code | 27856-7868 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154962751 | John Eaton | Technician | 762 Harare Lane, Nashville, NC 27856 | 2019-10-04 |
| 1073037735 | Ashley Hicks | Licensed Practical Nurse | 5972 Haywood Dr, Rocky Mount, NC 27856 | 2017-08-03 |
| 1538263173 | Progressive Rehab, Inc. | Clinic/Center | 143 Nashville Commons Drive, Nashville, NC 27856 | 2006-09-12 |
| 1174543730 | Jaclyn S Qualter | Nurse Practitioner | 120 W Washington Street, Nashville, NC 27856 | 2006-07-19 |
| 1699219311 | Sheryl Umstead | Counselor | 884 Robbins Lane, Nashville, NC 27856-0603 | 2016-12-14 |
| 1013043751 | Nash County Health Department | Clinical Medical Laboratory | 214 S Barnes St, Box 849, Nashville, NC 27856-0849 | 2007-02-26 |
| 1689954901 | By Faith Home Care Services, Inc | Home Health | 501 Western Ave, Nashville, NC 27856-1123 | 2011-08-17 |
| 1497880033 | County of Nash | Clinic/Center | 214 S Barnes St, Nashville, NC 27856-1204 | 2007-02-23 |
| 1013218395 | Rebecca I Wilkins | Dietitian, Registered | 214 S Barnes St, Nashville, NC 27856-1204 | 2010-11-03 |
| 1043423544 | Lori B. Taylor | Registered Nurse | 214 S Barnes St, Nashville, NC 27856-1204 | 2007-05-08 |
| Find all providers in zip 27856 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114563673 | Matthew Stancil Davenport | Custodial Care Facility | 2318 N Nc Highway 58, Nashville, NC 27856-9007 | 2019-11-20 |
| 1912362328 | Light of Hope Personal Care Home | Custodial Care Facility | 1010 E 6th Ave, Nashville, GA 31639-1747 | 2015-12-30 |
| 1326465089 | Eberechi Obi Onyejiaka | Custodial Care Facility | 525 Galesburg Ct., Nashville, TN 37217 | 2014-03-19 |
| 1275956112 | Alternative Care Inc.. | Custodial Care Facility | 525 Galesburg Ct, Nashville, TN 37217-4017 | 2014-01-29 |
| 1194952622 | Elder Assist By Estelle | Custodial Care Facility | 7200 Tolbert Rd, Nashville, TN 37209-5122 | 2009-06-10 |
| 1124299425 | Michael V Graves | Custodial Care Facility | 1819 Charlotte Avenue, Nashville, TN 37203 | 2008-03-14 |
| 1629249149 | Pro Nurse of Tn | Custodial Care Facility | 1819 Charlotte Ave, Nashville, TN 37203 | 2008-03-13 |
| 1144408394 | Bullock Family Care Home of Nashville Inc. | Custodial Care Facility | 619 S Boddie St, Nashville, NC 27856-1229 | 2008-02-08 |
| 1215394390 | Bradford House Family Care Home | Custodial Care Facility | 703 Bayberry Ln, Nashville, NC 27856-1578 | 2016-01-21 |
| 1285936880 | Above and Beyond Residential Living, Inc | Custodial Care Facility | 315 10th Ave N, Ste 122, Nashville, TN 37203-3498 | 2010-12-02 |
| Find all providers in NASHVILLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.