Provider Demographics
NPI:1366502882
Name:GOODNESS AND MERCY HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:GOODNESS AND MERCY HEALTH SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADESOLA
Authorized Official - Middle Name:O
Authorized Official - Last Name:OGUNDIPE
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:651-631-2535
Mailing Address - Street 1:831 OAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-6632
Mailing Address - Country:US
Mailing Address - Phone:651-631-2535
Mailing Address - Fax:651-631-2535
Practice Address - Street 1:831 OAKWOOD DR
Practice Address - Street 2:
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-6632
Practice Address - Country:US
Practice Address - Phone:651-631-2535
Practice Address - Fax:651-631-2535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN330588251E00000X
MN331795310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251E00000XAgenciesHome Health
Not Answered310400000XNursing & Custodial Care FacilitiesAssisted Living Facility