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General NPI Number Information
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NPI Number | 1033077987
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Entity Type | Organization
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Legal Business Name | TINY MIRACLES PEDIATRIC DAY CENTER LLC
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 109 LUCKNEY STATION RD
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City | FLOWOOD
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State | MS
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Zip | 39232-8402
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Country | US
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Telephone | 601-421-9367
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Fax | 601-510-9196
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Provider Business Mailing Address
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Address Line | 109 LUCKNEY STATION RD
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City | FLOWOOD
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State | MS
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Zip | 39232-8402
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Country | US
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Telephone | 601-421-9367
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Fax | 601-510-9196
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Authorized Official
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Title or Position | OWNER/ DIRECTOR
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Name | BRENDA BARRON
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Credential |
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Telephone | 601-421-9367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SL0600X
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Taxonomy Name | Long-Term Care Clinical Nurse Specialist
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License Number |
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License Number State |
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