Organization
MERCYLAND SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS FUNMI FEYIKEMI FASOLE ADMINISTRATOR (OWNER)
(770) 815-9471
Entity
Organization
Contact information
Practice address
4760 AUSTELL RD STE 6, AUSTELL, GA 30106-2007
(770) 574-4613
(770) 726-9783
Mailing address
4760 AUSTELL RD ,SUITE 6, AUSTELL, GA 30106-2007
(770) 574-4613
(770) 726-9783
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
033-R-0564
GA
Other
Enumeration date
09/16/2010
Last updated
06/15/2017
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