Provider Demographics
NPI:1356998256
Name:MIRACLE PATH STAFFING AGENCY
Entity type:Organization
Organization Name:MIRACLE PATH STAFFING AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:234-205-3541
Mailing Address - Street 1:123 S MILLER RD STE 225
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-4181
Mailing Address - Country:US
Mailing Address - Phone:234-205-3541
Mailing Address - Fax:330-523-7484
Practice Address - Street 1:123 S MILLER RD STE 225
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-4181
Practice Address - Country:US
Practice Address - Phone:234-205-3541
Practice Address - Fax:330-523-7484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-25
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health