Provider Demographics
NPI:1760930010
Name:LITTLE MIRACLES, INC PEDIATRIC THERAPY CLINIC
Entity Type:Organization
Organization Name:LITTLE MIRACLES, INC PEDIATRIC THERAPY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CENTER DIRECTOR AND THERAPY SERVICE
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-772-3851
Mailing Address - Street 1:2200 LIBRARY CIR
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-6326
Mailing Address - Country:US
Mailing Address - Phone:701-757-2155
Mailing Address - Fax:701-757-2156
Practice Address - Street 1:2200 LIBRARY CIR
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-6326
Practice Address - Country:US
Practice Address - Phone:701-757-2155
Practice Address - Fax:701-757-2156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-15
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1517261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation