Provider Demographics
NPI:1184052144
Name:SISTERS OF MERCY OF THE AMERICAS WEST MIDWEST COMMUNITY, INC.
Entity type:Organization
Organization Name:SISTERS OF MERCY OF THE AMERICAS WEST MIDWEST COMMUNITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMMUNITY FINANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDENBOSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-393-8225
Mailing Address - Street 1:7262 MERCY RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2389
Mailing Address - Country:US
Mailing Address - Phone:402-393-8225
Mailing Address - Fax:402-393-8145
Practice Address - Street 1:28750 W 11 MILE RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-1400
Practice Address - Country:US
Practice Address - Phone:248-473-7150
Practice Address - Fax:248-473-2557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO=========OtherEIN