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General NPI Number Information
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NPI Number | 1568762235
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Entity Type | Organization
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Legal Business Name | MINNIE'S MIRACLES
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Dates
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Enumeration Date | 10/28/2010
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Last Update Date | 10/28/2010
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Provider Practice Location Address
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Address Line | 1 MARION AVE SUITE 304
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City | MANSFIELD
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State | OH
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Zip | 44903-7920
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Country | US
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Telephone | 740-233-2626
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Fax | 740-223-2727
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Provider Business Mailing Address
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Address Line | 1 MARION AVE SUITE 304
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City | MANSFIELD
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State | OH
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Zip | 44903-7920
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Country | US
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Telephone | 740-233-2626
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Fax | 740-223-2727
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MRS. MINNIE E WHITEHEAD
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Credential |
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Telephone | 740-223-2626
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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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