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General NPI Number Information
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NPI Number | 1992503783
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Entity Type | Organization
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Legal Business Name | MIRALTA, LLC
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Dates
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Enumeration Date | 03/06/2025
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Last Update Date | 10/26/2025
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Provider Practice Location Address
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Address Line | 1363 VALLEY VIEW RD
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City | DUNWOODY
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State | GA
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Zip | 30338-4822
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Country | US
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Telephone | 770-880-3029
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Fax |
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Provider Business Mailing Address
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Address Line | 1363 VALLEY VIEW RD
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City | DUNWOODY
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State | GA
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Zip | 30338-4822
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Country | US
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Telephone | 770-880-3029
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Fax |
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Authorized Official
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Title or Position | CARE DIRECTOR
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Name | MR. PAOLO FORNASINI
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Credential | MBA
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Telephone | 404-828-0175
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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 |
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License Number State |
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Taxonomy #2
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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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