Provider Demographics
NPI:1265952584
Name:MIRACLES IN MOTION FOUNDATION
Entity type:Organization
Organization Name:MIRACLES IN MOTION FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:RAYE
Authorized Official - Last Name:HESTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-518-5008
Mailing Address - Street 1:4276 BURGOMEISTER PL
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-5905
Mailing Address - Country:US
Mailing Address - Phone:404-518-8404
Mailing Address - Fax:770-818-5723
Practice Address - Street 1:4276 BURGOMEISTER PLACE
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039
Practice Address - Country:US
Practice Address - Phone:404-518-8404
Practice Address - Fax:770-818-5723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management