Provider Demographics
NPI:1023520368
Name:MERCY REHABILITATION HOSPITAL, LLC
Entity type:Organization
Organization Name:MERCY REHABILITATION HOSPITAL, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HOSPITAL CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:NIGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-381-6519
Mailing Address - Street 1:1401 CAMPUS DRIVE
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-6500
Mailing Address - Country:US
Mailing Address - Phone:515-381-6519
Mailing Address - Fax:
Practice Address - Street 1:1401 CAMPUS DRIVE
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-6500
Practice Address - Country:US
Practice Address - Phone:515-381-6519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-26
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital