Healthcare Provider Details

I. General information

NPI: 1467228064
Provider Name (Legal Business Name): MIRACLE HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2023
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 BIRCH ST
BIDDEFORD ME
04005-3314
US

IV. Provider business mailing address

71 BIRCH ST
BIDDEFORD ME
04005-3314
US

V. Phone/Fax

Practice location:
  • Phone: 207-248-1554
  • Fax:
Mailing address:
  • Phone: 207-248-1554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: AYAT ALRAMMAHI
Title or Position: NONE MEDICAL HOME CARE
Credential:
Phone: 207-248-1554