Healthcare Provider Details

I. General information

NPI: 1407842552
Provider Name (Legal Business Name): MERCY HOME CARE & HOSPICE-CLINTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 09/29/2023
Certification Date: 09/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 13TH AVE N
CLINTON IA
52732-5067
US

IV. Provider business mailing address

915 13TH AVE N
CLINTON IA
52732-5067
US

V. Phone/Fax

Practice location:
  • Phone: 563-244-3766
  • Fax: 563-244-3719
Mailing address:
  • Phone: 563-244-3766
  • Fax: 563-244-3719

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number001008127
License Number StateIL

VIII. Authorized Official

Name: TIMOTHY T SHINBORI
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 563-244-3766