Organization
MINDING MIRACLES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN DEMARCO BCBA (PRESIDENT)
(848) 757-2123
Entity
Organization
Contact information
Practice address
405 HIGHWAY 36, PORT MONMOUTH, NJ 07758-1323
(732) 291-0810
(732) 291-0502
Mailing address
204 WILSON AVE, PORT MONMOUTH, NJ 07758-1228
(848) 757-2123
(732) 769-2343
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-19229
NJ
261QA0600X
Adult Day Care Clinic/Center
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0490113
—
NJ
Enumeration date
10/11/2017
Last updated
04/21/2024
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