Provider Demographics
NPI:1104281799
Name:MERCY HOME SERVICES
Entity type:Organization
Organization Name:MERCY HOME SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HANI
Authorized Official - Middle Name:OSMAN
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-886-5904
Mailing Address - Street 1:1609 HOOVER DR
Mailing Address - Street 2:12
Mailing Address - City:NORTH MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56003-2665
Mailing Address - Country:US
Mailing Address - Phone:612-886-5904
Mailing Address - Fax:612-354-3719
Practice Address - Street 1:2400 ELLIOT AVE
Practice Address - Street 2:321
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-3898
Practice Address - Country:US
Practice Address - Phone:612-886-5904
Practice Address - Fax:612-354-3719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-23
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)