Provider Demographics
NPI:1194372094
Name:MIRACLE PATH HOME CARE
Entity type:Organization
Organization Name:MIRACLE PATH HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-838-8650
Mailing Address - Street 1:345 MAIN ST STE 108B
Mailing Address - Street 2:
Mailing Address - City:HARLEYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19438-2420
Mailing Address - Country:US
Mailing Address - Phone:484-838-8650
Mailing Address - Fax:484-838-1094
Practice Address - Street 1:1150 FIRST AVE STE 501
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1316
Practice Address - Country:US
Practice Address - Phone:484-838-8650
Practice Address - Fax:484-838-1094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-25
Last Update Date:2024-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health