Provider Demographics
NPI:1629264528
Name:A MIRACULOUS TOUCH, INCORPORATED
Entity Type:Organization
Organization Name:A MIRACULOUS TOUCH, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:G
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-230-4668
Mailing Address - Street 1:4701 ALTAMESA BLVD
Mailing Address - Street 2:SUITE 2-C
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76133-6115
Mailing Address - Country:US
Mailing Address - Phone:817-230-4668
Mailing Address - Fax:817-350-4381
Practice Address - Street 1:4701 ALTAMESA BLVD
Practice Address - Street 2:SUITE 2-C
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76133-6115
Practice Address - Country:US
Practice Address - Phone:817-230-4668
Practice Address - Fax:817-350-4381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010544311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility