Provider Demographics
NPI:1205325073
Name:MIRACLE SUPPORT SERVICES.INC
Entity type:Organization
Organization Name:MIRACLE SUPPORT SERVICES.INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATACHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANASSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-460-1798
Mailing Address - Street 1:1565 QUAIL LAKE DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-4601
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1565 QUAIL LAKE DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-4601
Practice Address - Country:US
Practice Address - Phone:561-460-1798
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty