Mercy Favor and Grace Social Services

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

MERCY FAVOR AND GRACE SOCIAL SERVICES

Doing business as

Mercy Favor and Grace Residential Home

Practice address

9431 W Sheridan St
Phoenix, AZ 85037-4435

Phone

(602) 918-5492

Fax

(623) 223-9225

NPI assigned

Mar 10, 2020

Last updated

Mar 10, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Atinuke Comfort Okunade

Title

Program Director

Phone

(602) 918-5492

Specialties & licenses 1

Addresses

Other names 1

• Mercy Favor and Grace Residential Home Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1583798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583798400000",
    "number": "1942835806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9431 W SHERIDAN ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850374435",
            "telephone_number": "602-918-5492",
            "fax_number": "623-223-9225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9431 W SHERIDAN ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850374435",
            "telephone_number": "602-918-5492",
            "fax_number": "623-223-9225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY FAVOR AND GRACE SOCIAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-10",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A",
        "authorized_official_last_name": "OKUNADE",
        "authorized_official_first_name": "ATINUKE",
        "authorized_official_middle_name": "COMFORT",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "602-918-5492"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Favor and Grace Residential Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Meredith Hurt
• Brem Meredith, APRN, FNP-BC
• Keith S. Meredith, M.D.
• Carrie Mereness

• Mental Illness Community Based Residential Treatment Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Illness Community Based Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.