Healthcare Provider Details
I. General information
NPI: 1548184336
Provider Name (Legal Business Name): MIRACLE MINDS HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13 WILLOW DR
TOWNSEND MA
01469-1202
US
IV. Provider business mailing address
13 WILLOW DR
TOWNSEND MA
01469-1202
US
V. Phone/Fax
- Phone: 917-622-5374
- Fax:
- Phone: 917-622-5374
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HUDSON
SHAWN
SSEKILIME
Title or Position: CEO
Credential: FOUNDER
Phone: 917-622-5374