Provider Demographics
NPI:1912393661
Name:MIRACLES LLC
Entity Type:Organization
Organization Name:MIRACLES LLC
Other - Org Name:ANUVA BEAUTY SALON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:M
Authorized Official - Last Name:BELCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-761-2878
Mailing Address - Street 1:209 W CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLYN
Mailing Address - State:NJ
Mailing Address - Zip Code:08107-1522
Mailing Address - Country:US
Mailing Address - Phone:865-854-0918
Mailing Address - Fax:
Practice Address - Street 1:209 W CLINTON AVE
Practice Address - Street 2:
Practice Address - City:OAKLYN
Practice Address - State:NJ
Practice Address - Zip Code:08107-1522
Practice Address - Country:US
Practice Address - Phone:865-854-0918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-09
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ32WG03621800332BC3200X
NJ32WD03091500332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment