Provider Demographics
NPI:1669166823
Name:MIRACLES HOME CARE AGENCY LLC
Entity type:Organization
Organization Name:MIRACLES HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SOKOL
Authorized Official - Middle Name:
Authorized Official - Last Name:SERJANI
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP, FNP-C
Authorized Official - Phone:267-961-5801
Mailing Address - Street 1:2748 HELLERMAN ST SIDE B
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149-2939
Mailing Address - Country:US
Mailing Address - Phone:267-961-5801
Mailing Address - Fax:888-883-2366
Practice Address - Street 1:2748 HELLERMAN ST SIDE B
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19149-2939
Practice Address - Country:US
Practice Address - Phone:267-961-5801
Practice Address - Fax:888-883-2366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care