Provider Demographics
NPI:1841920147
Name:MIRACLE TOUCH AT HOME LLC.
Entity type:Organization
Organization Name:MIRACLE TOUCH AT HOME LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-235-2031
Mailing Address - Street 1:3900 WOODLAKE BLVD # 200-19
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-3044
Mailing Address - Country:US
Mailing Address - Phone:561-235-2031
Mailing Address - Fax:
Practice Address - Street 1:3900 WOODLAKE BLVD # 200-19
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-3044
Practice Address - Country:US
Practice Address - Phone:561-235-2031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health