Organization
HOUSE OF MERCY
Active
Other names
Substance Use Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
TODD BEVERIDGE (DIRECTOR)
(515) 247-3265
Entity
Organization
Contact information
Practice address
1409 CLARK ST, DES MOINES, IA 50314-1964
(515) 643-6525
Mailing address
1409 CLARK ST, DES MOINES, IA 50314-1964
(515) 643-6525
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1607560
MAGELLAN
IA
Enumeration date
04/11/2007
Last updated
08/22/2020
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