Provider Demographics
NPI:1427391242
Name:MATERNITY MIRACLES HOME CARE, LLC
Entity Type:Organization
Organization Name:MATERNITY MIRACLES HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:A
Authorized Official - Last Name:GILLIO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:215-479-2229
Mailing Address - Street 1:25 B WEST DELAWARE AVENUE
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534
Mailing Address - Country:US
Mailing Address - Phone:215-479-2229
Mailing Address - Fax:215-968-1889
Practice Address - Street 1:25 B WEST DELAWARE AVENUE
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534
Practice Address - Country:US
Practice Address - Phone:215-479-2229
Practice Address - Fax:215-968-1889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-29
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty