MEDICARE: MIRACLE HEARTS HOME HEALTH CARE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1538565437
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIRACLE HEARTS HOME HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	133 N ALTADENA DR STE 201
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91107-7328
Country	:	US
Telephone Number	:	818-616-3550
Fax Number	:	818-616-3560

Provider Business Practice Location Address
First Line	:	133 N ALTADENA DR STE 201
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91107-7328
Country	:	US
Telephone Number	:	818-616-3550
Fax Number	:	818-616-3560

Authorized Official
Title or Position	:	CEO
Name	:	JOHN LOUIE REGIS TOJONG
Credential	:
Telephone Number	:	818-616-3550

Provider Enumeration Date	:	11/05/2014
Last Update Date	:	06/17/2026

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