Organization
A&G MIRACLE HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENNIA S SOWELL (OWNER)
(731) 618-7369
Entity
Organization
Contact information
Practice address
107 N HALL ST, KENTON, TN 38233-1120
(731) 618-7369
Mailing address
340 WESTSIDE DR, HUMBOLDT, TN 38343-3101
(731) 618-7369
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
03/04/2019
Last updated
03/04/2019
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