# MERCYS SUPPORTIVE LIVING

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124418595
- **Authorized official:** ISAAC CONRAD BRAKE (ADMINISTRATOR)
- **Authorized official phone:** (252) 443-6811

## Contact information

- **Practice address:** 932 COBBLE RIDGE RD, NASHVILLE, NC 27856-7868
- **Practice address phone:** (252) 443-6811
- **Practice address fax:** (252) 443-6811
- **Mailing address:** 932 COBBLE RIDGE RD, NASHVILLE, NC 27856-7868
- **Mailing address phone:** (252) 443-6811
- **Mailing address fax:** (252) 443-6811

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | FCL064-027 | NC | Yes |

## Other

- **Enumeration date:** 01/23/2015
- **Last updated:** 03/04/2015