Provider Demographics
NPI:1497812812
Name:MIRACLES OF LIFE DAY SERVICES INC.
Entity Type:Organization
Organization Name:MIRACLES OF LIFE DAY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICKIE
Authorized Official - Middle Name:PIERRE
Authorized Official - Last Name:BROWN SR.
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-237-0484
Mailing Address - Street 1:5914 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60639-4013
Mailing Address - Country:US
Mailing Address - Phone:773-237-0484
Mailing Address - Fax:773-626-1077
Practice Address - Street 1:5914 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60639-4013
Practice Address - Country:US
Practice Address - Phone:773-237-0484
Practice Address - Fax:773-626-1077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care