Organization
MIRACLE FARM, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAY ALEXANDER HAMILTON (EXECUTIVE DIRECTOR)
(979) 836-0901
Entity
Organization
Contact information
Practice address
10802 FM 2621, BRENHAM, TX 77833-0164
(979) 836-0901
(979) 277-0939
Mailing address
10802 FM 2621, BRENHAM, TX 77833-0164
(979) 836-0901
(979) 277-0939
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
68824
TX
Other
Enumeration date
09/08/2017
Last updated
07/21/2022
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