Provider Demographics
NPI:1144805359
Name:NEW MERCY OUTREACH, INC.
Entity Type:Organization
Organization Name:NEW MERCY OUTREACH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORK SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-631-1633
Mailing Address - Street 1:PO BOX 123
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44901-0123
Mailing Address - Country:US
Mailing Address - Phone:419-631-1633
Mailing Address - Fax:
Practice Address - Street 1:50 HOME RD S
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OH
Practice Address - Zip Code:44906-2330
Practice Address - Country:US
Practice Address - Phone:419-631-1633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)