# MERCYLAND SERVICES LLC

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

## Provider details

- **NPI number:** 1194033886
- **Authorized official:** MISS FUNMI FEYIKEMI FASOLE ADMINISTRATOR (OWNER)
- **Authorized official phone:** (770) 815-9471

## Contact information

- **Practice address:** 4760 AUSTELL RD STE 6, AUSTELL, GA 30106-2007
- **Practice address phone:** (770) 574-4613
- **Practice address fax:** (770) 726-9783
- **Mailing address:** 4760 AUSTELL RD ,SUITE 6, AUSTELL, GA 30106-2007
- **Mailing address phone:** (770) 574-4613
- **Mailing address fax:** (770) 726-9783

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 033-R-0564 | GA | Yes |

## Other

- **Enumeration date:** 09/16/2010
- **Last updated:** 06/15/2017