Provider Demographics
NPI:1437457736
Name:MISSION OF MERCIFUL INC
Entity type:Organization
Organization Name:MISSION OF MERCIFUL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:WALE
Authorized Official - Middle Name:O
Authorized Official - Last Name:OLORUNDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:374-394-6080
Mailing Address - Street 1:2134 ELLIS AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-4707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:877-463-7470
Practice Address - Street 1:2134 ELLIS AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-4707
Practice Address - Country:US
Practice Address - Phone:347-394-6080
Practice Address - Fax:877-463-7470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
No251300000XAgenciesLocal Education Agency (LEA)
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care
No251V00000XAgenciesVoluntary or Charitable
No252Y00000XAgenciesEarly Intervention Provider Agency
No253Z00000XAgenciesIn Home Supportive Care
No302F00000XManaged Care OrganizationsExclusive Provider Organization
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No347C00000XTransportation ServicesPrivate Vehicle