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General NPI Number Information
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NPI Number | 1386342012
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Entity Type | Organization
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Legal Business Name | MIRACLE HOME HEALTHCARE, L.L.C
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Dates
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Enumeration Date | 02/22/2023
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Last Update Date | 06/12/2023
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Provider Practice Location Address
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Address Line | 133 N EDGEWOOD ST
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City | BALTIMORE
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State | MD
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Zip | 21229-3021
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Country | US
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Telephone | 443-802-6729
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Fax |
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Provider Business Mailing Address
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Address Line | 133 N EDGEWOOD ST
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City | BALTIMORE
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State | MD
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Zip | 21229-3021
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Country | US
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Telephone | 443-802-6729
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Fax | 443-802-6729
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Authorized Official
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Title or Position | C.E.O
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Name | MRS. TRACEY S. BROWN
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Credential | CNA
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Telephone | 443-802-6729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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