Provider Demographics
NPI:1851993695
Name:MINDING MIRACLES LEARNING CENTER
Entity Type:Organization
Organization Name:MINDING MIRACLES LEARNING CENTER
Other - Org Name:MINDING MIRACLES
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMARCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-757-2123
Mailing Address - Street 1:204 WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:PORT MONMOUTH
Mailing Address - State:NJ
Mailing Address - Zip Code:07758-1228
Mailing Address - Country:US
Mailing Address - Phone:732-682-6645
Mailing Address - Fax:
Practice Address - Street 1:204 WILSON AVE
Practice Address - Street 2:
Practice Address - City:PORT MONMOUTH
Practice Address - State:NJ
Practice Address - Zip Code:07758-1228
Practice Address - Country:US
Practice Address - Phone:848-757-2123
Practice Address - Fax:732-769-2343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-16
Last Update Date:2024-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty