Provider Demographics
NPI:1366247496
Name:MOTHER OF MERCY LLC
Entity type:Organization
Organization Name:MOTHER OF MERCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:C
Authorized Official - Last Name:ANIEKE
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:505-221-3586
Mailing Address - Street 1:6433 CENTENNIAL RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68157-2199
Mailing Address - Country:US
Mailing Address - Phone:505-221-3586
Mailing Address - Fax:
Practice Address - Street 1:2110 FLETCHER AVE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-5839
Practice Address - Country:US
Practice Address - Phone:505-221-3586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities