MERCY HEALTH SYSTEM CORPORATION NPI 1669685129

NPI Information

NPI: 1669685129
Provider Name: MERCY HEALTH SYSTEM CORPORATION

Doing Business As: MERCY OPTIONS BEHAVIORAL HEALTH

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
903 MINERAL POINT AVE
JANESVILLE, WI
ZIP 53548
Phone: (608) 756-5555
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MERCY HEALTH SYSTEM CORPORATION is a mental health (including community mental health center) clinic center in Janesville, WI. MERCY HEALTH SYSTEM CORPORATION NPI is 1669685129. The provider is registered as an organization entity type.
The provider Is Doing Business As Mercy Options Behavioral Health.

The provider's business location address is:

903 MINERAL POINT AVE
JANESVILLE, WI
ZIP 53548-970
Phone: (608) 756-5555
Fax: (608) 756-0174

The provider's authorized official is Todd Anderson .
The authorized official title is Vp/cfo and has the following contact phone number (815) 971-6752.

The enumeration date for this NPI number is 5/8/2007 and was last updated on 7/24/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261Q00000X	Clinic/Center		310-800	WISCONSIN	No
2	261QA0600X	Clinic/Center	Adult Day Care	310-800	WISCONSIN	No
3	261QR0400X	Clinic/Center	Rehabilitation	310-800	WISCONSIN	No
4	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	310-800	WISCONSIN	No
5	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	310800	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	42180321	MEDICAID	WISCONSIN
2	43171321	MEDICAID	WISCONSIN
3	42180221	MEDICAID	WISCONSIN
4	42232800	MEDICAID	WISCONSIN
5	42180300	MEDICAID	WISCONSIN
6	43009200	MEDICAID	WISCONSIN
7	11011426	MEDICAID	WISCONSIN
8	42180200	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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