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General NPI Number Information
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NPI Number | 1740946045
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Entity Type | Organization
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Legal Business Name | DIVINE MIRACLES HOME CARE AGENCY
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Dates
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Enumeration Date | 11/10/2021
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Last Update Date | 11/10/2021
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Provider Practice Location Address
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Address Line | 2173 EMBASSY DR
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City | LANCASTER
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State | PA
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Zip | 17603-2387
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Country | US
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Telephone | 717-923-5030
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Fax | 717-923-5031
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Provider Business Mailing Address
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Address Line | 2173 EMBASSY DR
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City | LANCASTER
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State | PA
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Zip | 17603-2387
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Country | US
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Telephone | 717-923-5030
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Fax | 717-923-5031
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Authorized Official
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Title or Position | CEO
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Name | MS. YECENIA LUZ PAGAN
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Credential | CEO
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Telephone | 717-923-5030
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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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