Provider Demographics
NPI:1902361280
Name:MERCY CARE HOME
Entity Type:Organization
Organization Name:MERCY CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:MUSA
Authorized Official - Middle Name:H
Authorized Official - Last Name:JIMAALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-226-0533
Mailing Address - Street 1:5005 WOODLAND RD
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-4520
Mailing Address - Country:US
Mailing Address - Phone:612-226-0533
Mailing Address - Fax:
Practice Address - Street 1:5005 WOODLAND RD
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-4520
Practice Address - Country:US
Practice Address - Phone:612-226-0533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility