Organization
MIRANDA HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY MIRANDA (OWNER)
(928) 304-1513
Entity
Organization
Contact information
Practice address
28229 E BORIS ST, WELLTON, AZ 85356-6651
(928) 304-1513
Mailing address
28229 E BORIS ST, WELLTON, AZ 85356-6651
(928) 304-1513
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
374U00000X
Home Health Aide
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
04/22/2020
Last updated
04/22/2020
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