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General NPI Number Information
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NPI Number | 1144805359
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Entity Type | Organization
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Legal Business Name | NEW MERCY OUTREACH, INC.
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Dates
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Enumeration Date | 03/10/2021
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Last Update Date | 03/10/2021
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Provider Practice Location Address
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Address Line | 50 HOME RD S
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City | ONTARIO
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State | OH
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Zip | 44906-2330
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Country | US
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Telephone | 419-631-1633
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 123
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City | MANSFIELD
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State | OH
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Zip | 44901-0123
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Country | US
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Telephone | 419-631-1633
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORK SUPERVISOR
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Name | SARAH CLOSE
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Credential |
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Telephone | 419-631-1633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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