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General NPI Number Information
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NPI Number | 1669909818
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Entity Type | Organization
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Legal Business Name | MERCY HOME CARE LTD
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Dates
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Enumeration Date | 05/18/2017
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Last Update Date | 06/22/2018
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Provider Practice Location Address
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Address Line | 1020 E 146TH ST STE 220D
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City | BURNSVILLE
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State | MN
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Zip | 55337
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Country | US
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Telephone | 952-378-1323
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Fax | 952-658-6798
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Provider Business Mailing Address
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Address Line | 1020 E 146TH ST STE 220D
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City | BURNSVILLE
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State | MN
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Zip | 55337-6757
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Country | US
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Telephone | 952-378-1323
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Fax | 952-658-6798
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Authorized Official
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Title or Position | CEO
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Name | KASSIM SHEIKH MOHAMED
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Credential |
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Telephone | 952-737-2945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 1084488-1-HCBS
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 1084488-1-HCBS
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 251T00000X
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Taxonomy Name | PACE Provider Organization
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License Number | 1084488-1-HCBS
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 1084488-1-HCBS
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License Number State | MN
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Taxonomy #5
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1084488-1-HCBS
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License Number State | MN
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