Organization
MIRACLE AFH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIAH RENE RODRIGUEZ (OWNER)
(262) 822-5305
Entity
Organization
Contact information
Practice address
3814 SAINT ANDREWS BLVD, RACINE, WI 53405-1728
(262) 822-5305
Mailing address
3814 SAINT ANDREWS BLVD, RACINE, WI 53405-1728
(262) 822-5305
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
08/25/2025
Last updated
09/15/2025
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