Provider Demographics
NPI:1417200155
Name:HOUSE OF MERCY
Entity Type:Organization
Organization Name:HOUSE OF MERCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALMEDINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ISLAMOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:515-643-6500
Mailing Address - Street 1:2009 NW ASHLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-8754
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1409 CLARK ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-1964
Practice Address - Country:US
Practice Address - Phone:515-643-6500
Practice Address - Fax:505-643-6532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility