Provider Demographics
NPI:1962032615
Name:MIRACLE HANDS HOME CARE AGENCY LTD
Entity Type:Organization
Organization Name:MIRACLE HANDS HOME CARE AGENCY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAIMUNA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARKAD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:678-262-8905
Mailing Address - Street 1:1403 JANICE CT SW
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-2348
Mailing Address - Country:US
Mailing Address - Phone:678-262-8905
Mailing Address - Fax:
Practice Address - Street 1:1403 JANICE CT SW
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-2348
Practice Address - Country:US
Practice Address - Phone:678-262-8905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care