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General NPI Number Information
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NPI Number | 1649703943
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Entity Type | Organization
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Legal Business Name | MIRACLEONE UNIVERSAL HEALTH CARE AND STAFFYING AGENCY, INC.
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Dates
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Enumeration Date | 04/04/2017
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Last Update Date | 04/05/2017
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Provider Practice Location Address
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Address Line | 4372 MORNINGWOOD DR
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City | OLNEY
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State | MD
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Zip | 20832-2829
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Country | US
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Telephone | 301-774-1560
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Fax | 301-774-9620
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Provider Business Mailing Address
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Address Line | 4372 MORNINGWOOD DR
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City | OLNEY
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State | MD
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Zip | 20832-2829
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Country | US
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Telephone | 301-774-1560
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Fax | 301-774-9620
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | MRS. OLGA MAUD SIMON
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Credential | RN, MSN, BSN
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Telephone | 301-774-1560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | RN965982
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | RN965982
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License Number State | DC
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