Provider Demographics
NPI:1679131205
Name:MIRACLE BABIES
Entity Type:Organization
Organization Name:MIRACLE BABIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAUN
Authorized Official - Middle Name:
Authorized Official - Last Name:ATTIQ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-497-4929
Mailing Address - Street 1:29364 CHELSEA XING
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-2807
Mailing Address - Country:US
Mailing Address - Phone:248-497-4929
Mailing Address - Fax:
Practice Address - Street 1:29364 CHELSEA XING
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-2807
Practice Address - Country:US
Practice Address - Phone:248-497-4929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251300000XAgenciesLocal Education Agency (LEA)
No252Y00000XAgenciesEarly Intervention Provider Agency