Organization
MIRACLE CARE HOSPICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDDIE LEE JR. (CEO)
(601) 982-1909
Entity
Organization
Contact information
Practice address
330 EDGEWOOD TERRACE DR, SUITE B, JACKSON, MS 39206-6216
(601) 982-1909
(601) 982-8177
Mailing address
330 EDGEWOOD TERRACE DR, SUITE B, JACKSON, MS 39206-6216
(601) 982-1909
(601) 982-8177
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
087
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07588281
—
MS
Enumeration date
01/24/2007
Last updated
08/22/2020
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