Provider Demographics
NPI:1316488364
Name:MIRACLE HEARTS & HANDS HOME CARE LLC
Entity type:Organization
Organization Name:MIRACLE HEARTS & HANDS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:KINDELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:912-227-8466
Mailing Address - Street 1:PO BOX 1198
Mailing Address - Street 2:
Mailing Address - City:KINGSLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31548-1198
Mailing Address - Country:US
Mailing Address - Phone:912-227-8466
Mailing Address - Fax:
Practice Address - Street 1:130 N WOODVALLEY DR
Practice Address - Street 2:
Practice Address - City:KINGSLAND
Practice Address - State:GA
Practice Address - Zip Code:31548-6669
Practice Address - Country:US
Practice Address - Phone:912-227-8466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health