Provider Demographics
NPI:1669230199
Name:MIRACLE'S HEAVENLY HANDS, LLC
Entity type:Organization
Organization Name:MIRACLE'S HEAVENLY HANDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MUSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARENAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-280-8091
Mailing Address - Street 1:602 N PARK ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-1525
Mailing Address - Country:US
Mailing Address - Phone:907-277-3256
Mailing Address - Fax:
Practice Address - Street 1:602 N PARK ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-1525
Practice Address - Country:US
Practice Address - Phone:907-277-3256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIRACLE'S HEAVENLY HANDS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility