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General NPI Number Information
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NPI Number | 1720393580
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Entity Type | Organization
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Legal Business Name | MINDING MIRACLES LEARNING CENTER
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Dates
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Enumeration Date | 08/17/2010
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Last Update Date | 04/21/2024
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Provider Practice Location Address
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Address Line | 405 HIGHWAY 36
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City | PORT MONMOUTH
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State | NJ
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Zip | 07758-1323
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Country | US
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Telephone | 848-757-2123
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Fax | 732-291-0502
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Provider Business Mailing Address
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Address Line | 204 WILSON AVE
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City | PORT MONMOUTH
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State | NJ
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Zip | 07758-1228
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Country | US
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Telephone | 732-682-6645
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Fax | 732-769-2343
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Authorized Official
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Title or Position | CEO
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Name | MISS ELIZABETH A DEMARCO
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Credential |
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Telephone | 848-757-2123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 12MIN0001
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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