Provider Demographics
NPI:1740657204
Name:MERCY LINK, LLC
Entity type:Organization
Organization Name:MERCY LINK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ABDURAHMAN
Authorized Official - Middle Name:WARSAMA
Authorized Official - Last Name:JAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-288-1135
Mailing Address - Street 1:7400 METRO BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2301
Mailing Address - Country:US
Mailing Address - Phone:952-222-5477
Mailing Address - Fax:952-222-5477
Practice Address - Street 1:13005 SALEM PL
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337
Practice Address - Country:US
Practice Address - Phone:952-856-2206
Practice Address - Fax:952-222-5418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-31
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1740657204Medicaid