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Organization
MIRRAH IMAGE SERVICES LLC
Active
Organization
MIRRAH IMAGE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER DICKENS (OWNER)
(407) 421-7324
Entity
Organization
Contact information
Practice address
2862 W MAIN ST, LEESBURG, FL 34748-4631
(407) 813-2112
Mailing address
2862 W MAIN ST, LEESBURG, FL 34748-4631
(407) 813-2112
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
NULL
251E00000X
Home Health Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
NULL
Other
Enumeration date
05/18/2020
Last updated
03/17/2026
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