Organization
TOTAL MIRACLE KIDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TIFFANY KENDALL (PRESIDENT)
(704) 854-8399
Entity
Organization
Contact information
Practice address
212 W SECOND AVE STE F, GASTONIA, NC 28052-4055
(704) 854-8399
(704) 854-8410
Mailing address
212 W SECOND AVE STE F, GASTONIA, NC 28052-4055
(704) 854-8399
(704) 854-8410
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC4236
NC
Other
Enumeration date
12/06/2010
Last updated
12/06/2010
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