Organization
MIRACLE WORKERS C.L.A. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA GREEN (OWNER)
(912) 247-8424
Entity
Organization
Contact information
Practice address
5 VINEYARD HAVEN DR, POOLER, GA 31322-8250
(912) 247-8424
Mailing address
PO BOX 7071, SAVANNAH, GA 31418-7071
(912) 247-8424
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
PCH001449
GA
Other
Enumeration date
10/13/2011
Last updated
10/13/2011
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