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General NPI Number Information
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NPI Number | 1720629587
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Entity Type | Organization
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Legal Business Name | MIRACLES IN ACTION LLC
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Dates
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Enumeration Date | 10/03/2019
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Last Update Date | 10/21/2022
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Provider Practice Location Address
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Address Line | 9241 RESEDA BLVD STE 200
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City | NORTHRIDGE
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State | CA
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Zip | 91324-3138
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Country | US
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Telephone | 818-429-9103
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Fax |
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Provider Business Mailing Address
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Address Line | 9241 RESEDA BLVD STE 200
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City | NORTHRIDGE
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State | CA
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Zip | 91324-3138
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Country | US
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Telephone | 818-429-9103
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Fax | 747-237-7860
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Authorized Official
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Title or Position | DIRECTOR/OPERATOR
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Name | AMNA BUTLER
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Credential |
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Telephone | 818-429-9103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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