Provider Demographics
NPI:1114521937
Name:CARING WITH MIRACLE HANDS, LLC
Entity Type:Organization
Organization Name:CARING WITH MIRACLE HANDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MIDDLEBROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-284-1861
Mailing Address - Street 1:3379 HIGHWAY 5 STE F
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-2377
Mailing Address - Country:US
Mailing Address - Phone:770-284-1861
Mailing Address - Fax:720-368-8755
Practice Address - Street 1:3379 HIGHWAY 5 STE F
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-2377
Practice Address - Country:US
Practice Address - Phone:770-284-1861
Practice Address - Fax:720-368-8755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003240322OtherINSURANCE COMPANIES