Organization
MIRACLE HOME CARE II LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRDELL MCGRUDER (CEO)
(314) 349-5419
Entity
Organization
Contact information
Practice address
3725 LINCOLN AVE, SAINT LOUIS, MO 63113-3521
(314) 349-5419
Mailing address
3725 LINCOLN AVE, SAINT LOUIS, MO 63113-3521
(314) 349-5419
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
10/29/2024
Last updated
10/29/2024
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