Mercy Autism Center LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MERCY AUTISM CENTER LLC

Practice address

2817 Anthony LN S Ste 214
St Anthony, MN 55418-2885

Phone

(612) 414-8698

NPI assigned

Sep 21, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Abdulkhaliq Osman

Title

Owner

Phone

(612) 886-5838

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695254400000",
    "number": "1093593816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ANTHONY LN S STE 214",
            "city": "ST ANTHONY",
            "state": "MN",
            "postal_code": "554182885",
            "telephone_number": "612-886-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ANTHONY LN S STE 214",
            "city": "ST ANTHONY",
            "state": "MN",
            "postal_code": "554182885",
            "telephone_number": "612-414-8698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY AUTISM CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-21",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A",
        "authorized_official_last_name": "OSMAN",
        "authorized_official_first_name": "ABDULKHALIQ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-886-5838"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in St Anthony, MN
• Providers in St Anthony, MN by specialty
• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.