Organization
MERCYGATE HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEO SENGSAVANG MA (CREDENTIALING AGENT)
(612) 234-1823
Entity
Organization
Contact information
Practice address
2647 BLOOMINGTON AVE, MINNEAPOLIS, MN 55407-1137
(612) 282-2053
Mailing address
2647 BLOOMINGTON AVE, MINNEAPOLIS, MN 55407-1137
(612) 282-2053
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
02/20/2025
Last updated
02/20/2025
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