Organization
MIRACLE MILES MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONJANIKA BALLARD (BUSINESS CONSULTANT)
(804) 441-8538
Entity
Organization
Contact information
Practice address
5841 SNEAD RD, RICHMOND, VA 23224-4661
(804) 688-9777
Mailing address
5841 SNEAD RD, RICHMOND, VA 23224-4661
(804) 688-9777
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/08/2024
Last updated
11/08/2024
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