Organization
MIRACLE LIVING HOMECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA JOHNSTON RN (OWNER)
(763) 221-6529
Entity
Organization
Contact information
Practice address
7038 BROOKLYN BLVD STE I, BROOKLYN CENTER, MN 55429-1370
(763) 221-6529
Mailing address
9401 WHITE OAKS TRL, CHAMPLIN, MN 55316-2677
(763) 221-6529
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
06/28/2023
Last updated
12/06/2023
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