Provider Demographics
NPI:1649052820
Name:A MIRACLE LLC
Entity type:Organization
Organization Name:A MIRACLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PETRONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-444-8987
Mailing Address - Street 1:31904 CALHOUN CT
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-4708
Mailing Address - Country:US
Mailing Address - Phone:734-444-8987
Mailing Address - Fax:734-725-5466
Practice Address - Street 1:31904 CALHOUN CT
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-4708
Practice Address - Country:US
Practice Address - Phone:734-444-8987
Practice Address - Fax:734-725-5466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No177F00000XOther Service ProvidersLodging
No253Z00000XAgenciesIn Home Supportive Care