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General NPI Number Information
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NPI Number | 1366243784
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Entity Type | Organization
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Legal Business Name | MIRACLE HOME CARE
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Dates
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Enumeration Date | 03/21/2025
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 6660 CORTEZ CIR
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-2323
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Country | US
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Telephone | 229-214-8977
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Fax |
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Provider Business Mailing Address
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Address Line | 6660 CORTEZ CIR
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-2323
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Country | US
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Telephone | 229-214-8977
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SEQUOYAH MOORE
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Credential |
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Telephone | 228-280-5347
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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