Provider Demographics
NPI:1811225709
Name:MERCY HOME HEALTHCARE AGENCY CORP
Entity Type:Organization
Organization Name:MERCY HOME HEALTHCARE AGENCY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:N
Authorized Official - Last Name:GODWIN-OPARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-263-1511
Mailing Address - Street 1:2102 E 21ST ST N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-1943
Mailing Address - Country:US
Mailing Address - Phone:316-263-1511
Mailing Address - Fax:316-651-0361
Practice Address - Street 1:2102 E 21ST ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-1943
Practice Address - Country:US
Practice Address - Phone:316-263-1511
Practice Address - Fax:316-651-0361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-03
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA087133251E00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care