Healthcare Provider Details

I. General information

NPI: 1538565437
Provider Name (Legal Business Name): MIRACLE HEARTS HOME HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2014
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 N ALTADENA DR STE 201
PASADENA CA
91107-7328
US

IV. Provider business mailing address

133 N ALTADENA DR STE 201
PASADENA CA
91107-7328
US

V. Phone/Fax

Practice location:
  • Phone: 818-616-3550
  • Fax: 818-616-3560
Mailing address:
  • Phone: 818-616-3550
  • Fax: 818-616-3560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JOHN LOUIE REGIS TOJONG
Title or Position: CEO
Credential:
Phone: 818-616-3550