Provider Demographics
NPI:1952615635
Name:MIRACLES BEHAVIORAL, INC
Entity Type:Organization
Organization Name:MIRACLES BEHAVIORAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:804-400-6479
Mailing Address - Street 1:9100 ARBORETUM PKWY STE 365
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23236-3493
Mailing Address - Country:US
Mailing Address - Phone:804-400-6479
Mailing Address - Fax:
Practice Address - Street 1:9100 ARBORETUM PKWY STE 365
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23236-3493
Practice Address - Country:US
Practice Address - Phone:804-400-6479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care