Organization
MIRACULUM CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ABDULATIF HAMZA ABDULRAHMAN (DIRECTOR)
(651) 366-9972
Entity
Organization
Contact information
Practice address
220 ROBERT ST S STE 204-6, SAINT PAUL, MN 55107-1677
(651) 366-9972
Mailing address
20430 GATEWAY DR, LAKEVILLE, MN 55044-5098
(651) 366-9972
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
07/25/2024
Last updated
09/03/2024
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