Organization
HOUSE OF MIRACLES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. XAVIER L JENKINS LASAC (CEO)
(602) 488-8880
Entity
Organization
Contact information
Practice address
1951 W CAMELBACK RD # 255, PHOENIX, AZ 85015-3403
(623) 203-7381
Mailing address
10720 W INDIAN SCHOOL RD # 19-245, PHOENIX, AZ 85037-5721
(623) 203-7381
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
05/26/2023
Last updated
05/26/2023
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