Healthcare Provider Details

I. General information

NPI: 1154278364
Provider Name (Legal Business Name): MIRACLE HANDS CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 S 23RD ST
GRAND FORKS ND
58201-5177
US

IV. Provider business mailing address

1222 S 23RD ST
GRAND FORKS ND
58201-5177
US

V. Phone/Fax

Practice location:
  • Phone: 218-693-9244
  • Fax:
Mailing address:
  • Phone: 218-693-9244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. THOMAS MAH JR.
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 218-693-9244