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NPI Code Detail

MEDICARE: MIRACLES OF LOVE HEALTH AGENCY LLC

MEDICARE: MIRACLES OF LOVE HEALTH AGENCY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1253Z00000XIn Home Supportive Care Agency
23747P1801XPersonal Care Attendant
3251B00000XCase Management Agency

General Provider Information

NPI Number : 1376386698
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIRACLES OF LOVE HEALTH AGENCY LLC
Provider Business Mailing Address
First Line : 2351 W NORTHWEST HWY STE 1306
Second Line :
City : DALLAS
State : TX
Zip : 75220-4433
Country : US
Telephone Number : 945-321-0629
Fax Number :
Provider Business Practice Location Address
First Line : 2351 W NORTHWEST HWY STE 1306
Second Line :
City : DALLAS
State : TX
Zip : 75220-4433
Country : US
Telephone Number : 945-321-0629
Fax Number :
Authorized Official
Title or Position : SENIOR CASE MANAGER
Name : RADONICA STEWARD
Credential :
Telephone Number : 214-497-2037
Provider Enumeration Date : 06/14/2024
Last Update Date : 12/08/2025

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Directions to “MIRACLES OF LOVE HEALTH AGENCY LLC ” Practice Location

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