Provider Demographics
NPI:1831999002
Name:MIRACLE WORKS LTD.
Entity type:Organization
Organization Name:MIRACLE WORKS LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEAVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-991-3540
Mailing Address - Street 1:8041 CRAWFORDSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46214-1531
Mailing Address - Country:US
Mailing Address - Phone:317-991-3540
Mailing Address - Fax:317-991-3540
Practice Address - Street 1:8041 CRAWFORDSVILLE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46214-1531
Practice Address - Country:US
Practice Address - Phone:317-991-3540
Practice Address - Fax:317-991-3540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health