Provider Demographics
NPI:1184462608
Name:HEART OF MERCY
Entity type:Organization
Organization Name:HEART OF MERCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:KAMAU
Authorized Official - Last Name:NJUGUNA
Authorized Official - Suffix:
Authorized Official - Credentials:ADULT FAMILY HOME
Authorized Official - Phone:206-670-5387
Mailing Address - Street 1:6332 S C ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98408-6310
Mailing Address - Country:US
Mailing Address - Phone:206-670-5387
Mailing Address - Fax:253-240-4525
Practice Address - Street 1:6332 S C ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98408-6310
Practice Address - Country:US
Practice Address - Phone:206-670-5387
Practice Address - Fax:253-240-4525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care