MEDICARE: MERCY WELLNESS SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1720643240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCY WELLNESS SERVICES

Provider Business Mailing Address
First Line	:	2647 BLOOMINGTON AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-1187
Country	:	US
Telephone Number	:	952-297-2050
Fax Number	:

Provider Business Practice Location Address
First Line	:	2647 BLOOMINGTON AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-1187
Country	:	US
Telephone Number	:	952-297-2050
Fax Number	:

Authorized Official
Title or Position	:	OPERATION MANAGER
Name	:	MR. MOHAMED F ARAB
Credential	:
Telephone Number	:	952-297-2050

Provider Enumeration Date	:	05/09/2019
Last Update Date	:	05/09/2019

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Directions to “MERCY WELLNESS SERVICES ” Practice Location

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