Organization
MIRACLE HOME CARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHASHICKA TONSHAY HILL (PRESIDENT)
(912) 264-9242
Entity
Organization
Contact information
Practice address
4220 CORAL PARK DR., BRUNSWICK, GA 31520
(912) 264-9242
(921) 264-9665
Mailing address
4220 CORAL PARK DR, BRUNSWICK, GA 31520-3016
(912) 264-9242
(912) 264-9665
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
063-R-0013
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
927869260A
—
GA
Enumeration date
05/14/2009
Last updated
05/14/2009
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